IndividualActive
Ahmed Radwan, M.D.
NPI 1376575126 · Sports Medicine (Family Medicine) Physician · O Fallon, IL
Provider details
- NPI number
- 1376575126
- Entity type
- Individual
- Primary specialty
- Sports Medicine (Family Medicine) PhysicianAllopathic & Osteopathic Physicians
- Credential
- M.D.
- Sex
- Male
- Sole proprietor
- Yes
- License
- 036114529 (IL)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Practice location
670 Pierce Blvd
O Fallon, IL 62269-2579
Phone: (618) 206-2070
Fax: (618) 206-2071
Approximate (ZIP-level) locationGet directions
Mailing address
1512 N Green Mount Rd
O Fallon, IL 62269-1953
Registry dates
- Enumerated
- 2006-07-06
- Last updated
- 2021-12-30
- Certified
- 2021-12-30
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.