Provider Demographics
NPI:1750518650
Name:KANAWATI, EYAD (MD)
Entity type:Individual
Prefix:
First Name:EYAD
Middle Name:
Last Name:KANAWATI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 8500-6335
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19178-0001
Mailing Address - Country:US
Mailing Address - Phone:215-807-8000
Mailing Address - Fax:215-807-8235
Practice Address - Street 1:370 MIDDLETOWN BLVD
Practice Address - Street 2:STE 510
Practice Address - City:LANGHORNE
Practice Address - State:PA
Practice Address - Zip Code:19047-1840
Practice Address - Country:US
Practice Address - Phone:215-750-6566
Practice Address - Fax:215-750-7288
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-18
Last Update Date:2016-05-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD446457207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease