Basic Information
| Provider Information | |||||||||
| NPI: | 1871904599 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | AWAD | ||||||||
| FirstName: | ELIAS | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | P.O. BOX 172328 | ||||||||
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| City: | DENVER | ||||||||
| State: | CO | ||||||||
| PostalCode: | 802172328 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3033067783 | ||||||||
| FaxNumber: | 3033067753 | ||||||||
| Practice Location | |||||||||
| Address1: | 1719 E 19TH AVE | ||||||||
| Address2: | |||||||||
| City: | DENVER | ||||||||
| State: | CO | ||||||||
| PostalCode: | 802181235 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3034362727 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/15/2014 | ||||||||
| LastUpdateDate: | 08/08/2017 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207P00000X | 201708 | NC | N | Allopathic & Osteopathic Physicians | Emergency Medicine | 207P00000X | DR.0058884 | CO | Y | Allopathic & Osteopathic Physicians | Emergency Medicine |
No ID Information.