Individual
DR. IBRAHIM ISAMAIL GHANNAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1850 N CENTRAL AVE, STE 1600, PHOENIX, AZ 85004-4633
(602) 262-8900
Mailing address
242 W MAHOGANY PL, CHANDLER, AZ 85248-6387
(480) 861-3401
(480) 861-3401
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
005544
AZ
207L00000X
Anesthesiology Physician
2308
WV
Other
Enumeration date
06/29/2007
Last updated
06/13/2018
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