Ghaida Awwad, RDN

Individual provider Active NPI Registered Dietitian · O Fallon, MO

NPI 1467110320 · NPPES record last updated Dec 7, 2021

Key facts

NPI
1467110320
Entity type
Individual (NPI type 1)
Primary specialty
Registered Dietitian 133V00000X
License
86051892 (MO)
Practice address
1012 Rock Creek Elementary School Dr
O Fallon, MO 63366-7576
Phone
(314) 736-8686
NPI assigned
Dec 7, 2021
Sex
Female
Sole proprietor
Yes

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
86051892MOMDRegistered Dietitian

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 86051892 MO Yes

Addresses

Primary practice location

1012 Rock Creek Elementary School Dr
O Fallon, MO 63366-7576

Mailing address

1012 Rock Creek Elementary School Dr
O Fallon, MO 63366-7576
Phone (314) 736-8686

Other providers in O Fallon, MO

All providers in O Fallon, MO · Registered Dietitian in Missouri

Sources for this page

Verify at the official NPI Registry.