Sam H Awada, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

4301079394 Issued in MI

Practice address

12640 E 12 Mile Rd
Warren, MI 48093-3520

Phone

(586) 751-2020

Fax

(586) 745-4756

NPI assigned

Sep 29, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

Practice roles

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.

• Midwest Family Practices, PLC

  • Family Medicine Physician
  • Warren, MI
  • NPI 1770819864
  NPD (past) Authorized official
• 24 Hour Pharmacy RX Store

  • Community/Retail Pharmacy
  • Warren, MI
  • NPI 1518230721
  NPD (past)

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

{
    "created_epoch": "1127952000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707955200000",
    "number": "1811984594",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12640 E 12 MILE RD",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480933520",
            "telephone_number": "586-751-2020",
            "fax_number": "586-751-7872"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12640 E 12 MILE RD",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480933520",
            "telephone_number": "586-751-2020",
            "fax_number": "586-745-4756"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AWADA",
        "first_name": "SAM",
        "middle_name": "H",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-29",
        "last_updated": "2024-02-15",
        "certification_date": "2024-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301079394",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4905372",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4692522",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM GROUP #",
            "identifier": "700E018250",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Autumn Woods Residential Health Care Facility LLC
• Autumn Woods Residential Health Care Facility LLC
• Imelda Cua Avila, P.T.
• Avotre Health LLC
• Maher Kassem Awada, RPH
• Samuel Awada, RPH
• Hamdah W Awan
• Kenneth Axelrad, PH.D.
• Madalyn J Axford, FNP-BC
• Salonas Rafael Ayad

• Family Medicine Physician in Warren, MI
• Providers in Warren, MI by specialty
• Family Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.