FADI Z GHANDOUR (NPI# 1487659199) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1487659199 |
| Entity Type | Individual |
| Full Name | FADI Z GHANDOUR |
| Credential | MD |
| Practice Address |
1836 South Ave La Crosse WI 54601-5429 |
| Practice Telephone | 6087827300 |
| Mailing Telephone | 6087827300 |
| Enumeration Date | 2005-06-17 |
| Last Update Date | 2015-11-12 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207RN0300X |
Internal Medicine Specialization: Nephrology |
52225 | MN | Allopathic & Osteopathic Physicians |
| Y | 207RN0300X |
Internal Medicine Specialization: Nephrology |
40941 | WI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 32581500 | 05 |
| Street Address |
1836 SOUTH AVE |
| City | LA CROSSE |
| State | WI |
| Zip Code | 54601-5429 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952304834 | Susan G Maclellan-tobert | Pediatrics | 1836 South Ave, La Crosse, WI 54601-5429 | 2005-05-24 |
| 1861099590 | Ellen Compton | Dietitian, Registered | 1836 South Ave, La Crosse, WI 54601-5429 | 2020-10-06 |
| 1699382630 | Jedd Sebion | Pharmacist | 1836 South Ave, La Crosse, WI 54601-5429 | 2020-09-24 |
| 1104436351 | Taryn Jean Simon | Speech-Language Pathologist | 1836 South Ave, La Crosse, WI 54601-5429 | 2020-08-03 |
| 1497376438 | Eva Igler | Student in an Organized Health Care Education/Training Program | 1836 South Ave, La Crosse, WI 54601-5429 | 2020-04-30 |
| 1568083608 | Benjamin Haase Thompson | Student in an Organized Health Care Education/Training Program | 1836 South Ave, La Crosse, WI 54601-5429 | 2020-04-29 |
| 1316568736 | Eric Bobel | Student in an Organized Health Care Education/Training Program | 1836 South Ave, La Crosse, WI 54601-5429 | 2020-04-27 |
| 1134749708 | Kristin Danielle Heslep | Student in an Organized Health Care Education/Training Program | 1836 South Ave, La Crosse, WI 54601-5429 | 2020-04-23 |
| 1982224598 | Rebecca Stanek | Student in an Organized Health Care Education/Training Program | 1836 South Ave, La Crosse, WI 54601-5429 | 2020-04-23 |
| 1609496595 | Marie Gilberte Cineus | Student in an Organized Health Care Education/Training Program | 1836 South Ave, La Crosse, WI 54601-5429 | 2020-04-21 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891324265 | Meagan Mcrae | Student in an Organized Health Care Education/Training Program | 1725 State St., 4051 Health Science Center, La Crosse, WI 54601 | 2020-04-07 |
| 1255969671 | Erin Dingman | Student in an Organized Health Care Education/Training Program | 1751 State Street, 4051 Health Science Center, La Crosse, WI 54601 | 2020-03-31 |
| 1619505047 | Nicole Kay Lynch | Student in an Organized Health Care Education/Training Program | 4051 Health Science Center, 1725 State St, La Crosse, WI 54601 | 2020-03-31 |
| 1174151757 | Jenna Sells | Student in an Organized Health Care Education/Training Program | 4051 Health Science Center, 1725 State Street, La Crosse, WI 54601 | 2020-03-30 |
| 1740818301 | Katie Irene Tahtinen | Student in an Organized Health Care Education/Training Program | Uwl- 4051 Health Science Center, 1725 State St., La Crosse, WI 54601 | 2020-03-30 |
| 1932737517 | Margaret May Grimm | Student in an Organized Health Care Education/Training Program | Univesity of Wisconsin-la Crosse, 4051 Health Science Center, 1725 State Street, La Crosse, WI 54601 | 2020-03-30 |
| 1831727312 | Matthew Timothy Axler | Student in an Organized Health Care Education/Training Program | 4051 Health Science Center, 1725 State Street, La Crosse, WI 54601 | 2020-03-30 |
| 1093340473 | Denise Stinson | Technician | 1311 Badger St, Apt 505, La Crosse, WI 54601 | 2020-03-06 |
| 1922632397 | Ibrahim Ahsan | Pharmacist | 1105 Wi-16, La Crosse, WI 54601 | 2020-02-25 |
| 1750913356 | Liza R Collins | Massage Therapist | 1415 State Wi 16, La Crosse, WI 54601 | 2020-02-11 |
| Find all providers in zip 54601 | ||||
| Taxonomy Code | 207RN0300X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Nephrology |
| An internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154551968 | Arvind Kumar Garg | Internal Medicine | 700 West Ave S, La Crosse, WI 54601-4783 | 2009-07-15 |
| 1679607709 | Sumaiya Waseem Siddiqi | Internal Medicine | 1836 South Ave, La Crosse, WI 54601-5429 | 2007-03-14 |
| 1265592372 | Bashar A Omari | Internal Medicine | 700 West Ave S, La Crosse, WI 54601 | 2006-12-11 |
| 1386648947 | Wilfrido R Yutuc | Internal Medicine | 1836 South Ave, La Crosse, WI 54601-5429 | 2005-06-10 |
| 1467456244 | Balaji Srinivasan | Internal Medicine | 1836 South Ave, La Crosse, WI 54601-5429 | 2005-06-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841823390 | Kelby Roholt | Internal Medicine | 305 E Mahn Ct, Oak Creek, WI 53154-2101 | 2020-02-12 |
| 1477186922 | Sydney Kemps | Internal Medicine | 507 N 17th St, Milwaukee, WI 53233-5495 | 2020-02-12 |
| 1053708511 | Rishi Kora | Internal Medicine | 5650 N Green Bay Ave Ste 210, Glendale, WI 53209-4447 | 2015-04-22 |
| 1841523818 | Sana Waheed | Internal Medicine | 301 S Yellowstone Dr Apt 306, Madison, WI 53705-4378 | 2009-09-09 |
| 1841426798 | Wisconsin Vascular Access and Nephrology | Internal Medicine | 1962 N Prospect Ave # 310, Milwaukee, WI 53202-1414 | 2009-06-05 |
| 1184865099 | Zurab Albekioni | Internal Medicine | 3000 Westhill Dr Ste 108, Wausau, WI 54401-3795 | 2009-03-23 |
| 1104095017 | Mark Y Nunag | Internal Medicine | 2050 Continential Drive, West Bend, WI 53095 | 2008-02-25 |
| 1649448259 | Crystalkinetics, LLC | Internal Medicine | 4113 N Lake Dr, Shorewood, WI 53211-1720 | 2008-02-16 |
| 1699975193 | Dawn Wolfgram | Internal Medicine | 5000 W National Ave # Cc-111k, Milwaukee, WI 53295-1000 | 2007-07-23 |
| 1366657710 | Deepak Sharma | Internal Medicine | 7797 W Appletone Ave, Milwaukee, WI 53222 | 2007-05-11 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.