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Individual
EDWARD G GHATTAS
Active
Individual
EDWARD G GHATTAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
005164
AZ
207Q00000X
Family Medicine Physician
5101011159
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
080093523
METRAHEALTH
MI
01
—
080D410020
BLUE CROSS BLUE SHIELD
MI
01
—
0852524385
HEALTH PLUS
MI
01
—
204373
HEALTH ADVANTAGE NETWORK
MI
01
—
2341129003
CIGNA
MI
05
—
3327505
—
MI
05
—
425169
—
AZ
01
—
5895095
AETNA
MI
01
—
C2472
MCARE
MI
01
—
F78381
HEALTH NET FEDERAL
MI
Enumeration date
10/27/2005
Last updated
01/20/2020
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