Provider Demographics
NPI:1669540423
Name:GHANEM, GHAZI ANTOUN (MD)
Entity type:Individual
Prefix:DR
First Name:GHAZI
Middle Name:ANTOUN
Last Name:GHANEM
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1450 E A ST
Mailing Address - Street 2:STE 1
Mailing Address - City:CASPER
Mailing Address - State:WY
Mailing Address - Zip Code:82601-2239
Mailing Address - Country:US
Mailing Address - Phone:307-234-8700
Mailing Address - Fax:307-234-8750
Practice Address - Street 1:1450 E A ST
Practice Address - Street 2:STE 1
Practice Address - City:CASPER
Practice Address - State:WY
Practice Address - Zip Code:82601-2239
Practice Address - Country:US
Practice Address - Phone:307-234-8700
Practice Address - Fax:307-234-8750
Is Sole Proprietor?:No
Enumeration Date:2006-12-01
Last Update Date:2013-07-17
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Provider Licenses
StateLicense IDTaxonomies
WY7375A207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease