Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 111N00000X | Chiropractor | 1169 | AL |
N | 111NS0005X | Chiropractic Sports Physician | 1169 | AL |
NPI | 1093718777 |
---|---|
Provider Name | Dr. Khalil Elias Awad |
First Address | Birmingham, AL 35206-1559 |
Second Address | Birmingham, AL 35206-1559 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/05/2005 |
Last Update Date | 08/07/2007 |