Provider Demographics
NPI:1336190701
Name:AWAIDA, AMY BETH (MD)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:BETH
Last Name:AWAIDA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 786536
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19178-6536
Mailing Address - Country:US
Mailing Address - Phone:330-318-1100
Mailing Address - Fax:330-318-1111
Practice Address - Street 1:835 SOUTHWESTERN RUN
Practice Address - Street 2:
Practice Address - City:YOUNGSTOWN
Practice Address - State:OH
Practice Address - Zip Code:44514-3688
Practice Address - Country:US
Practice Address - Phone:330-318-1100
Practice Address - Fax:330-318-1111
Is Sole Proprietor?:No
Enumeration Date:2006-05-12
Last Update Date:2018-11-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OH35090895207RH0003X
KY39920207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology