MEDICARE: MOLECA MAHMOUD GHANNAM

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207T00000X	Neurological Surgery Physician	D0105854	MD

General Provider Information

NPI Number	:	1962067157
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MOLECA MAHMOUD GHANNAM

Provider Business Mailing Address
First Line	:	49918 HANCOCK ST
Second Line	:
City	:	CANTON
State	:	MI
Zip	:	48188-6660
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	49918 HANCOCK ST
Second Line	:
City	:	CANTON
State	:	MI
Zip	:	48188-6660
Country	:	US
Telephone Number	:	734-985-5746
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/03/2019
Last Update Date	:	04/16/2026

Similar Medicare Providers

1174831218 — CANTON PHYSICAL MEDICARE, LLC
Practice Location Address:

2050 CUMMING HWY , SUITE 100
CANTON, GA
30114-8614

Practice Phone: 770-345-9600
Practice Fax:

1083567341 — SELINA LOUISE VOLPONE PA-C
Practice Location Address:

42231 PALMER RD
CANTON, MI
48188-1911

Practice Phone: 734-578-8568
Practice Fax:

1689461675 — EZ-WAY HOME HEALTH LLC
Practice Location Address:

40315 MICHIGAN AVE # 501
CANTON, MI
48188-2908

Practice Phone: 248-973-7184
Practice Fax:

1164366480 — JAY PATEL PTA
Practice Location Address:

3951 NORWICH DR
CANTON, MI
48188-7232

Practice Phone: 732-372-1159
Practice Fax: 866-620-1406

1205417672 — DANIEL CHINTHAKA AMARASINGHE MD
Practice Location Address:

1600 S CANTON CENTER RD STE 210
CANTON, MI
48188-6276

Practice Phone: 734-786-2300
Practice Fax: 734-786-4915

1538001524 — KATIA ADAMS
Practice Location Address:

41148 CANTON CT
CANTON, MI
48188-1466

Practice Phone: 734-512-3913
Practice Fax:

Directions to “ MOLECA MAHMOUD GHANNAM ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.