Active NPI
Moleca Mahmoud Ghannam
- Neurological Surgery Physician
- Canton, MI
National Provider Identifier
1962067157
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neurological Surgery Physician
- License
- D0105854
- Practice address
- 49918 Hancock St
Canton, MI 48188-6660 - Phone
- (734) 985-5746
- NPI assigned
- May 3, 2019
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Neurological Surgery Physician | 207T00000X | D0105854 | MD | Primary |
Addresses
Primary practice location
49918 Hancock St
Canton, MI 48188-6660
Mailing address
49918 Hancock St
Canton, MI 48188-6660
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MD
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20260612000283 | MD | Practitioner - Neurosurgery | 3971075763 |
Care Compare profile
Medicare Care Compare- Specialty
- Neurosurgery
- Education
- Oakland Univ, William Beaumont School of Medicine, 2019
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
22 S Green St
Baltimore, MD 21201-1544
250 W Pratt St
Baltimore, MD 21201-2463
250 W Pratt St
Suite 500
Baltimore, MD 21201-2500
250 W Pratt St
Suite 900
Baltimore, MD 21201-2423
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D0105854 | MD | MD | Neurological Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1556841600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1776297600000",
"number": "1962067157",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "49918 HANCOCK ST",
"city": "CANTON",
"state": "MI",
"postal_code": "481886660"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "49918 HANCOCK ST",
"city": "CANTON",
"state": "MI",
"postal_code": "481886660",
"telephone_number": "734-985-5746"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GHANNAM",
"first_name": "MOLECA",
"middle_name": "MAHMOUD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-05-03",
"last_updated": "2026-04-16",
"certification_date": "2026-04-16",
"status": "A"
},
"taxonomies": [
{
"code": "207T00000X",
"taxonomy_group": "",
"desc": "Neurological Surgery",
"state": "MD",
"license": "D0105854",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Canton, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.