Individual
WAEL I GHANIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
305 LANGDON ST, SOMERSET, KY 42503-2750
(606) 679-7441
Mailing address
305 LANGDON ST, SOMERSET, KY 42503-2750
(606) 679-7441
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
38144
KY
208000000X
Pediatrics Physician
MD446646
PA
208M00000X
Hospitalist Physician
38144
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000312935
ANTHEM BC/BS
—
05
—
010038227
—
VA
05
—
4046618
—
TN
05
—
64072358
—
KY
Enumeration date
05/15/2006
Last updated
09/15/2021
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