Active NPI
Ikram Ghani, MD
- Internal Medicine Physician
- Dearborn, MI
National Provider Identifier
1154572360
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 4301067738
- Practice address
- 15400 Michigan Ave
Ste 1
Dearborn, MI 48126-3491 - Phone
- (313) 584-3359
- NPI assigned
- Oct 7, 2008
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 4301067738 | MI | Primary |
Addresses
Primary practice location
15400 Michigan Ave
Ste 1
Dearborn, MI 48126-3491
Mailing address
2032 Martin Grove Rd.
Etobicoke, ONTARIO MAV4B6
CA
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 418244910 | Medicaid | MI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4301067738 | MI | MD | Internal Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1223337600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1235520000000",
"number": "1154572360",
"addresses": [
{
"country_code": "CA",
"country_name": "Canada",
"address_purpose": "MAILING",
"address_type": "FGN",
"address_1": "2032 MARTIN GROVE RD.",
"city": "ETOBICOKE",
"state": "ONTARIO",
"postal_code": "MAV4B6"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15400 MICHIGAN AVE",
"address_2": "STE 1",
"city": "DEARBORN",
"state": "MI",
"postal_code": "481263491",
"telephone_number": "313-584-3359"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GHANI",
"first_name": "IKRAM",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-10-07",
"last_updated": "2009-02-25",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "MI",
"license": "4301067738",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "418244910",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Dearborn, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.