Individual
ELIAS CAMILLE GHANDOUR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5601 LOCH RAVEN BLVD, STE 3, BALTIMORE, MD 21239-2905
(443) 444-3775
(443) 444-4678
Mailing address
5601 LOCH RAVEN BLVD, STE 3 N, BALTIMORE, MD 21239-2905
(443) 444-3775
(443) 444-4678
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
D0035706
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
206901200
—
MD
01
—
52322301
BLUE SHIELD
MD
Enumeration date
06/27/2005
Last updated
05/19/2010
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