Organization Active NPI

Ammar Ghanem MD PLLC

  • Pulmonary Disease Physician
  • Rochester Hills, MI
National Provider Identifier
1346790896
Registry record updated Oct 8, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
01067395A Issued in IN
Legal business name
AMMAR GHANEM MD PLLC
Practice address
950 W Avon Rd
A2
Rochester Hills, MI 48307-2761
Phone
(248) 651-6430
Fax
(248) 650-1382
NPI assigned
Oct 8, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Ammar Ghanem, M.D.NPI 1528026424
Title
Owner
Phone
(248) 651-6430

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RP1001X 01067395A IN Primary

Addresses

Primary practice location

950 W Avon Rd
A2
Rochester Hills, MI 48307-2761

Mailing address

950 W Avon Rd
A2
Rochester Hills, MI 48307-2761
Phone (248) 651-6430

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20161227001085 MI Part B Supplier - Clinic/Group Practice 3870874225 Receives reassigned benefits from 2 practitioners
Practice locations: Rochester Hills, MI; Eaton Rapids, MI; Pontiac, MI; Lapeer, MI; Lansing, MI; Bay City, MI

National Provider Directory

National Provider Directory

Locations

950 W Avon Rd
#A2
Rochester Hills, MI 48307
Phone (248) 651-6430

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1475884800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1475884800000",
    "number": "1346790896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "950 W AVON RD",
            "address_2": "A2",
            "city": "ROCHESTER HILLS",
            "state": "MI",
            "postal_code": "483072761",
            "telephone_number": "248-651-6430",
            "fax_number": "248-650-1382"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "950 W AVON RD",
            "address_2": "A2",
            "city": "ROCHESTER HILLS",
            "state": "MI",
            "postal_code": "483072761",
            "telephone_number": "248-651-6430",
            "fax_number": "248-650-1382"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMMAR GHANEM MD PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-08",
        "last_updated": "2016-10-08",
        "status": "A",
        "authorized_official_last_name": "GHANEM",
        "authorized_official_first_name": "AMMAR",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "248-651-6430",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "IN",
            "license": "01067395A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester Hills, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.