Provider Demographics
NPI:1881034791
Name:GHUNEIM, GEORGE JOHN (DO)
Entity Type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:JOHN
Last Name:GHUNEIM
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 E PARIS AVE SE STE 200
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49546-8383
Mailing Address - Country:US
Mailing Address - Phone:616-685-3450
Mailing Address - Fax:616-685-3454
Practice Address - Street 1:1000 E PARIS AVE SE STE 200
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49546-8383
Practice Address - Country:US
Practice Address - Phone:616-685-3450
Practice Address - Fax:616-685-3454
Is Sole Proprietor?:No
Enumeration Date:2013-06-25
Last Update Date:2021-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101020326207RC0000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine