Provider Demographics
NPI:1124052154
Name:AWAR, MAHER MARK (MD)
Entity type:Individual
Prefix:DR
First Name:MAHER
Middle Name:MARK
Last Name:AWAR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2051 W 25TH ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:YUMA
Mailing Address - State:AZ
Mailing Address - Zip Code:85364-6912
Mailing Address - Country:US
Mailing Address - Phone:928-317-1119
Mailing Address - Fax:928-317-1129
Practice Address - Street 1:2051 W 25TH ST
Practice Address - Street 2:SUITE A
Practice Address - City:YUMA
Practice Address - State:AZ
Practice Address - Zip Code:85364-6912
Practice Address - Country:US
Practice Address - Phone:928-317-1119
Practice Address - Fax:928-317-1129
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2011-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ34515174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ104920Medicare ID - Type Unspecified
AZH80872Medicare UPIN