Provider Demographics
NPI:1952489403
Name:AYAD, MEDHAT SAAD (MD)
Entity Type:Individual
Prefix:
First Name:MEDHAT
Middle Name:SAAD
Last Name:AYAD
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 1:145 OAKVIEW RD
Mailing Address - Street 2:
Mailing Address - City:CARBONDALE
Mailing Address - State:IL
Mailing Address - Zip Code:62901-8162
Mailing Address - Country:US
Mailing Address - Phone:808-375-2473
Mailing Address - Fax:
Practice Address - Street 1:35 ALBANY RD
Practice Address - Street 2:SUITE C
Practice Address - City:CARBONDALE
Practice Address - State:IL
Practice Address - Zip Code:62903-7646
Practice Address - Country:US
Practice Address - Phone:618-457-5111
Practice Address - Fax:618-457-6560
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2020-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036130568207L00000X
CAC55847207L00000X
MI4301051660207L00000X, 207LC0200X, 207LP2900X
HIMD11402207LC0200X, 207LP2900X
IN01043849A207LC0200X, 207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Not Answered207LC0200XAllopathic & Osteopathic PhysiciansAnesthesiologyCritical Care Medicine
Not Answered207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI242297OtherHMSA QUEST 65+
HI00000000000000000000OtherHAWAII LABORERS
HI00000000000000000000OtherUNIVERSITY HEALTH ALLIANC
HI53919001Medicaid
HI00000000000000000000OtherCHAMPUS - TRICARE
HI00000000000000000000OtherHMA, INC.
HI00000000000000000000OtherALOHA CARE QUEST
HI00000000000000000000OtherHMAA
HIG07847Medicare UPIN
HI55985Medicare ID - Type Unspecified