1750529665 NPI number — DR. HADY ANTOINE GHANEM M.D,

Table of content: DR. HADY ANTOINE GHANEM M.D, (NPI 1750529665)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1750529665 NPI number — DR. HADY ANTOINE GHANEM M.D,

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
GHANEM
Provider First Name:
HADY
Provider Middle Name:
ANTOINE
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D,
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1750529665
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/29/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2440 VIRGINIA AVE NW
Provider Second Line Business Mailing Address:
APTD803
Provider Business Mailing Address City Name:
WASHINGTON
Provider Business Mailing Address State Name:
DC
Provider Business Mailing Address Postal Code:
20037-2601
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
609-320-0378
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2150 PENNSYLVANIA AVE NW
Provider Second Line Business Practice Location Address:
SUITE 5-404
Provider Business Practice Location Address City Name:
WASHINGTON
Provider Business Practice Location Address State Name:
DC
Provider Business Practice Location Address Postal Code:
20037-3201
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
202-741-2255
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/30/2009

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 390200000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)