| Wael I Ghanim, MD | |
|
305 Langdon St, Somerset, KY 42503-2750 | |
| (606) 679-7441 | |
| Not Available |
| Full Name | Wael I Ghanim |
|---|---|
| Gender | Male |
| Speciality | Pediatrics |
| Location | 305 Langdon St, Somerset, Kentucky |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841241668 | NPI | - | NPPES |
| 010038227 | Medicaid | VA | |
| 4046618 | Medicaid | TN | |
| 64072358 | Medicaid | KY | |
| 000000312935 | Other | ANTHEM BC/BS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208000000X | Pediatrics | MD446646 (Pennsylvania) | Secondary |
| 208M00000X | Hospitalist | 38144 (Kentucky) | Secondary |
| 208000000X | Pediatrics | 38144 (Kentucky) | Primary |
| Entity Name | Kentucky Medical Services Foundation, Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1326091448 PECOS PAC ID: 5698689909 Enrollment ID: O20031119000300 |
| Entity Name | Appalachian Regional Healthcare Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1871189019 PECOS PAC ID: 0840107835 Enrollment ID: O20031125000520 |
| Entity Name | Lake Cumberland Regional Hospital Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1861078685 PECOS PAC ID: 7214909456 Enrollment ID: O20040809001229 |
| Entity Name | Clark Regional Physician Practices Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1780356253 PECOS PAC ID: 9739337569 Enrollment ID: O20120919000575 |
| Mailing Address | Practice Location Address |
|---|---|
| Wael I Ghanim, MD 305 Langdon St, Somerset, KY 42503-2750 Ph: (606) 679-7441 | Wael I Ghanim, MD 305 Langdon St, Somerset, KY 42503-2750 Ph: (606) 679-7441 |
Cherice K Patterson, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 350 Langdon St, Somerset, KY 42503 Phone: 606-678-8155 Fax: 606-678-7548 | |
Harry Lee Greene, M. D. Pediatrics Medicare: Medicare Enrolled Practice Location: 205 Waitsboro Dr, Somerset, KY 42503 Phone: 561-317-3387 Fax: 606-451-9728 | |
Rebecca Jeannine Blakley, CPNP Pediatrics Medicare: Medicare Enrolled Practice Location: 350 Hospital Way Ste 100, Somerset, KY 42503 Phone: 865-207-3466 | |
Deanna Marie Grubbs, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 350 Langdon St, Somerset, KY 42503 Phone: 606-678-8155 Fax: 606-678-7548 | |
Dr. Lisette Marie Garrett, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 350 Langdon St, Somerset, KY 42503 Phone: 606-678-8155 Fax: 606-678-7548 | |
Dr. Sheeba M. Picard, D.O. Pediatrics Medicare: Medicare Enrolled Practice Location: 350 Langdon Street, Somerset, KY 42503 Phone: 606-678-8155 Fax: 606-678-7548 | |
Melissa G Hansford, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 350 Langdon St, Suite 1, Somerset, KY 42503 Phone: 606-678-8155 Fax: 606-678-7548 |