Individual
AMMAR GHANEM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
75 BARCLAY CIR STE 205, ROCHESTER HILLS, MI 48307-5821
(260) 416-5892
(260) 416-5897
Mailing address
75 BARCLAY CIR STE 205, ROCHESTER HILLS, MI 48307-5821
(248) 651-6430
(260) 416-5897
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
35085090
OH
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
01067395
IN
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
35085090
OH
207RP1001X
Pulmonary Disease Physician
01067395
IN
207RP1001X
Pulmonary Disease Physician
35085090
OH
207RP1001X
Pulmonary Disease Physician
Primary
4301111042
MI
207RS0012X
Sleep Medicine (Internal Medicine) Physician
01067395
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000658707
ANTHEM
IN
05
—
1346790896
—
MI
05
—
200982500
—
IN
05
—
2626420
—
OH
01
—
7424707
AETNA
IN
Enumeration date
05/02/2006
Last updated
10/21/2020
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