Healthcare Provider Details

I. General information

NPI: 1275730285
Provider Name (Legal Business Name): AHMED MOHAMMED GHANY M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/02/2007
Last Update Date: 12/06/2022
Certification Date: 12/06/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

75 HOSPITAL DR STE 170
ATHENS OH
45701-2865
US

IV. Provider business mailing address

PO BOX 7527
DUBLIN OH
43017-0727
US

V. Phone/Fax

Practice location:
  • Phone: 740-331-7112
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License Number35.058949
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: