Individual
DR. JOHN GANIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1 MEDICAL VILLAGE DR, EDGEWOOD, KY 41017-3403
(859) 301-2250
(859) 572-2326
Mailing address
PO BOX 18667, ERLANGER, KY 41018-0667
(859) 572-3617
(859) 572-2326
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
01058778A
IN
207P00000X
Emergency Medicine Physician
Primary
36022
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200407670
—
IN
05
—
2089298
—
OH
05
—
64012768
—
KY
Enumeration date
08/02/2005
Last updated
06/01/2021
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