Provider Demographics
NPI:1649359944
Name:KANJ, GHASSAN HANI (MD)
Entity type:Individual
Prefix:DR
First Name:GHASSAN
Middle Name:HANI
Last Name:KANJ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:99 J D ANDERSON DR
Mailing Address - Street 2:SUITE 5A
Mailing Address - City:MORGANTOWN
Mailing Address - State:WV
Mailing Address - Zip Code:26505-4000
Mailing Address - Country:US
Mailing Address - Phone:304-598-2801
Mailing Address - Fax:304-599-6463
Practice Address - Street 1:99 J D ANDERSON DR
Practice Address - Street 2:SUITE 5A
Practice Address - City:MORGANTOWN
Practice Address - State:WV
Practice Address - Zip Code:26505-4000
Practice Address - Country:US
Practice Address - Phone:304-598-2801
Practice Address - Fax:304-599-6463
Is Sole Proprietor?:No
Enumeration Date:2006-11-06
Last Update Date:2025-02-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD453818207RS0012X, 207RC0200X
WV19742207RP1001X
DEC1-0024495207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep Medicine
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV0075141000Medicaid
WV0075141000Medicaid
WVG87535Medicare UPIN
WV0868663Medicare PIN