Provider Demographics
NPI:1649251380
Name:GANEM, JAMES FERRIS (MD)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:FERRIS
Last Name:GANEM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:595 N DOBSON RD
Mailing Address - Street 2:SUITE C-48
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85224-4226
Mailing Address - Country:US
Mailing Address - Phone:480-899-9430
Mailing Address - Fax:480-899-9554
Practice Address - Street 1:595 N DOBSON RD
Practice Address - Street 2:SUITE C-48
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85224-4226
Practice Address - Country:US
Practice Address - Phone:480-899-9430
Practice Address - Fax:480-899-9554
Is Sole Proprietor?:No
Enumeration Date:2005-11-09
Last Update Date:2014-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ16666207RI0011X, 207UN0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207UN0901XAllopathic & Osteopathic PhysiciansNuclear MedicineNuclear Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
1356334346OtherGROUP NPI
1356334346OtherGROUP NPI
E47391Medicare UPIN