Basic Information
Provider Information
NPI: 1669918462
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ELAWADY
FirstName: AKRAM
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
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OtherMiddleName:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 420 S JACKSON ST
Address2:  
City: POTTSVILLE
State: PA
PostalCode: 179013625
CountryCode: US
TelephoneNumber: 5706215000
FaxNumber:  
Practice Location
Address1: 1901 N DUPONT HWY
Address2:  
City: NEW CASTLE
State: DE
PostalCode: 197201100
CountryCode: US
TelephoneNumber: 3022552700
FaxNumber:  
Other Information
ProviderEnumerationDate: 01/17/2017
LastUpdateDate: 01/07/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 01/07/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2084P0800XC7-0006398DEN Allopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
2084P0800XMD471426PAY Allopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry

No ID Information.


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