# EDWARD G GHATTAS

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1164412466
- **Gender:** Man
- **Credential:** DO

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 005164 | AZ | Yes |
| 207Q00000X | Family Medicine Physician | 5101011159 | MI | — |

## Other

- **Enumeration date:** 10/27/2005
- **Last updated:** 01/20/2020

## 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 |