Provider Demographics
NPI:1649257080
Name:TAWAKOL, AHMED A (MD)
Entity type:Individual
Prefix:DR
First Name:AHMED
Middle Name:A
Last Name:TAWAKOL
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:PO BOX 9142
Mailing Address - Street 2:MASS GENERAL PHYSICIAN ORGANIZATION
Mailing Address - City:CHARLESTOWN
Mailing Address - State:MA
Mailing Address - Zip Code:02129-9142
Mailing Address - Country:US
Mailing Address - Phone:617-726-0786
Mailing Address - Fax:617-724-4152
Practice Address - Street 1:55 FRUIT ST YAW 5
Practice Address - Street 2:CARDIAC UNIT ASSOCIATES
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02114-2696
Practice Address - Country:US
Practice Address - Phone:617-724-6750
Practice Address - Fax:617-724-6767
Is Sole Proprietor?:No
Enumeration Date:2005-12-28
Last Update Date:2012-11-19
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Provider Licenses
StateLicense IDTaxonomies
MA80137207R00000X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA080137OtherTUFTS HEALTH PLAN
MA3201830Medicaid
MAJ19523OtherBCBS MA
MAJ19523OtherBCBS MA
MAA29861Medicare ID - Type Unspecified