Individual
FIRAS GHANEM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1185 CORPORATE CENTER DR, OCONOMOWOC, WI 53066-4887
(262) 928-8800
Mailing address
201 N. MAYFAIR RD. 2ND FLOOR, WAUWATOSA, WI 53226
(414) 259-7505
(414) 259-7583
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
01072445A
IN
207RC0000X
Cardiovascular Disease Physician
01072445A
IN
207RC0000X
Cardiovascular Disease Physician
Primary
64436
WI
207RI0011X
Interventional Cardiology Physician
01072445A
IN
207RI0011X
Interventional Cardiology Physician
64436
WI
Other
Enumeration date
01/20/2006
Last updated
05/14/2020
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