Individual provider Active NPI

Michael Awadalla, M.D.

  • Surgery Physician
  • Cincinnati, OH
National Provider Identifier
1063849909
Registry record updated Oct 10, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
57023284 Issued in OH
Practice address
4777 E Galbraith Rd
Cincinnati, OH 45236-2725
Phone
(513) 686-5466
NPI assigned
Oct 10, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 57023284 OH Primary

Addresses

Primary practice location

4777 E Galbraith Rd
Cincinnati, OH 45236-2725

Mailing address

7115 Ravens Run
Cincinnati, OH 45244-3594
Phone (859) 468-7698

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
57023284OHMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Institute for Reproductive Health Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1381363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1381363200000",
    "number": "1063849909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7115 RAVENS RUN",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452443594",
            "telephone_number": "859-468-7698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4777 E GALBRAITH RD",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452362725",
            "telephone_number": "513-686-5466"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AWADALLA",
        "first_name": "MICHAEL",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-10-10",
        "last_updated": "2013-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "OH",
            "license": "57023284",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.