Alexander David Ghannam, MD is a medicare enrolled "Student In An Organized Health Care Education/training Program" physician in Jacksonville, Florida. His current practice location is
653-1 W 8th St, Jacksonville, Florida. You can reach out to his office (for appointments etc.) via phone at
(904) 244-3903.
Alexander David Ghannam is licensed to practice in Florida (license number TRN26700) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1043715501.
Physician's Profile
Full Name | Alexander David Ghannam |
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Gender | Male |
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Speciality | Student In An Organized Health Care Education/training Program |
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Location | 653-1 W 8th St, Jacksonville, Florida |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1043715501
- Provider Enumeration Date: 03/27/2018
- Last Update Date: 10/18/2019
Medicare PECOS Information:
- PECOS PAC ID: 9234489139
- Enrollment ID: I20180913000699
Medical Identifiers
Medical identifiers for Alexander David Ghannam such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1043715501 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
208600000X | Surgery | TRN26700 (Florida) | Secondary |
390200000X | Student In An Organized Health Care Education/training Program | TRN26700 (Florida) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Alexander David Ghannam is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Alexander David Ghannam, MD 655 W 8th St, Jacksonville, FL 32209-6511 Ph: (904) 244-3903 | Alexander David Ghannam, MD 653-1 W 8th St, Jacksonville, FL 32209-6511 Ph: (904) 244-3903 |
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