Individual
JACOB SAIED GHANNAM JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3601 W 13 MILE RD, ROYAL OAK, MI 48073-6712
(248) 898-5000
Mailing address
26901 BEAUMONT BLVD, SOUTHFIELD, MI 48033-3849
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
4301505324
MI
Other
Enumeration date
04/18/2019
Last updated
08/05/2025
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