Provider Demographics
NPI:1376716738
Name:JOHN G. GHUNEIM M.D. P.C.
Entity Type:Organization
Organization Name:JOHN G. GHUNEIM M.D. P.C.
Other - Org Name:INNOVATIONS IN HEALTH, INC.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:GEORGE
Authorized Official - Last Name:GHUNEIM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:734-429-2581
Mailing Address - Street 1:1235 INDUSTRIAL DR
Mailing Address - Street 2:SUITE 6
Mailing Address - City:SALINE
Mailing Address - State:MI
Mailing Address - Zip Code:48176-1741
Mailing Address - Country:US
Mailing Address - Phone:734-429-2581
Mailing Address - Fax:734-429-3410
Practice Address - Street 1:1235 INDUSTRIAL DR
Practice Address - Street 2:SUITE 6
Practice Address - City:SALINE
Practice Address - State:MI
Practice Address - Zip Code:48176-1741
Practice Address - Country:US
Practice Address - Phone:734-429-2581
Practice Address - Fax:734-429-3410
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-08
Last Update Date:2008-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ON88440Medicare PIN