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General NPI Number Information
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NPI Number | 1306854948
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Entity Type | Individual
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Provider Name | MAGED MAHMOUD GHANEM MD
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Gender | Male
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Dates
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Enumeration Date | 08/03/2006
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Last Update Date | 09/04/2024
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Provider Practice Location Address
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Address Line | 232 W 25TH ST
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City | ERIE
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State | PA
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Zip | 16544-0002
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Country | US
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Telephone | 814-452-5980
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Fax | 824-452-5039
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Provider Business Mailing Address
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Address Line | PO BOX 644850
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City | PITTSBURGH
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State | PA
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Zip | 15264-4850
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Country | US
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Telephone | 412-937-8887
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Fax | 412-937-9221
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | MD432272
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License Number State | PA
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