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General NPI Number Information
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NPI Number | 1912506940
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Entity Type | Individual
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Provider Name | MOHAMMED GHONEIM
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Gender | Male
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Dates
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Enumeration Date | 10/21/2020
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Last Update Date | 06/30/2025
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Provider Practice Location Address
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Address Line | 15835 KNOLLWOOD DR
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City | DEARBORN
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State | MI
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Zip | 48120-1347
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Country | US
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Telephone | 929-523-3501
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Fax |
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Provider Business Mailing Address
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Address Line | 1001 MAIN ST # K3502
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City | BUFFALO
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State | NY
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Zip | 14203-1009
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Country | US
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Telephone |
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Fax |
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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 | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 307927
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 33325
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License Number State | NH
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