Provider Demographics
NPI:1528355070
Name:AWALE, MILIND SUMANT (MD)
Entity type:Individual
Prefix:DR
First Name:MILIND SUMANT
Middle Name:
Last Name:AWALE
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 1:1 MEDICAL PARK
Mailing Address - Street 2:
Mailing Address - City:WHEELING
Mailing Address - State:WV
Mailing Address - Zip Code:26003-6300
Mailing Address - Country:US
Mailing Address - Phone:304-243-2981
Mailing Address - Fax:304-243-3964
Practice Address - Street 1:1 MEDICAL PARK
Practice Address - Street 2:
Practice Address - City:WHEELING
Practice Address - State:WV
Practice Address - Zip Code:26003-6300
Practice Address - Country:US
Practice Address - Phone:304-243-2981
Practice Address - Fax:304-243-3964
Is Sole Proprietor?:No
Enumeration Date:2011-07-06
Last Update Date:2022-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.132649208M00000X
WV25644207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0112949Medicaid
WV1528355070Medicaid