Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YX0905X | Otolaryngology/Facial Plastic Surgery | 311086 | NY |
NPI | 1356754626 |
---|---|
Provider Name | Dr. Mahmoud Issam Awad |
First Address | Binghamton, NY 13905-1040 |
Second Address | Johnson City, NY 13790-2161 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/06/2014 |
Last Update Date | 21/10/2021 |