| Doctor Name: | DR. NIMAE N. AWANTANG |
| NPI Number: | 1124156468 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | M.D. |
| License Number: | 23996 |
| Business Practice Address: | 625 W. Baldwin Rd Ste C. Panama City, FL - 32405 |
| Business Phone Number: | 8507696612 |
| Business Fax Number: | 8507693553 |
| Mailing Address: | 1702 Ohio Ave, LYNN HAVEN |
| State: | FL |
| Postal Code: | 32444 |
| Phone Number: | 8505715844 |
| Fax Number: | 8505715845 |
| NPI Enumeration Date: | 02/28/2007 |
| NPI Last Update Date: | 04/14/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 23996 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | FL |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |