Organization
ALLIANCE TELEMED LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. AYMAN A GHONIEM MD (SOLE MEMBER)
(812) 320-7229
Entity
Organization
Contact information
Practice address
2600 S HENDERSON ST, SUITE 122, BLOOMINGTON, IN 47401-8439
(812) 320-7229
Mailing address
2600 S HENDERSON ST, SUITE 122, BLOOMINGTON, IN 47401-8439
(812) 320-7229
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
01056877
IN
Other
Enumeration date
10/25/2010
Last updated
11/25/2012
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