Individual
DR. AMJAD AZZAWE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1335 MOUNT VERNON ST, PHILADELPHIA, PA 19123-3211
(214) 238-9055
Mailing address
127 W SALAIGNAC ST, PHILADELPHIA, PA 19127-1820
(318) 230-4105
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RP454477
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RP454477
PA PHARMACIST LICENSE
PA
Enumeration date
06/25/2020
Last updated
06/25/2020
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