| Erieside Medical Group | |
|
38429 Lake Shore Blvd Willoughby OH 44094-7009 | |
| (440) 946-9200 | |
| Not Available |
| Full Name | Erieside Medical Group |
|---|---|
| Speciality | Family Medicine |
| Location | 38429 Lake Shore Blvd, Willoughby, Ohio |
| Authorized Official Name and Position | Winston Ho (PRESIDENT) |
| Authorized Official Contact | 4402697483 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Erieside Medical Group 38429 Lake Shore Blvd Willoughby OH 44094-7009 Ph: (440) 946-9200 | Erieside Medical Group 38429 Lake Shore Blvd Willoughby OH 44094-7009 Ph: (440) 946-9200 |
| NPI Number | 1891751657 |
|---|---|
| Provider Enumeration Date | 04/21/2006 |
| Last Update Date | 06/10/2010 |
| Medicare PECOS PAC ID | 8325099716 |
|---|---|
| Medicare Enrollment ID | O20050202000910 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891751657 | NPI | - | NPPES |
| Provider Name | Winston Ho |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1194802454 PECOS PAC ID: 1850342247 Enrollment ID: I20100608000671 |
| Provider Name | James Andrew Mandelik |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1154408490 PECOS PAC ID: 0941251334 Enrollment ID: I20100610000067 |
| Provider Name | Jessica Riggs |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689071748 PECOS PAC ID: 8921325358 Enrollment ID: I20150324002397 |
| Provider Name | Tawana M Cunningham |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841674009 PECOS PAC ID: 2769790179 Enrollment ID: I20151005003097 |
| Provider Name | Iryna Cribley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508139023 PECOS PAC ID: 3072776939 Enrollment ID: I20151210001956 |
Signature Health Inc. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 38882 Mentor Ave, Willoughby, OH 44094 Phone: 440-953-9999 | |
Signature Health, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 38876 Mentor Ave, Willoughby, OH 44094 Phone: 440-953-9999 | |
Diane M. Cornicelli, M.d. Inc, Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 36001 Euclid Ave, Suite C-19, Willoughby, OH 44094 Phone: 216-374-9664 | |
Primehealth Internal Medicine Willoughby Hills Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2747 Som Center Rd, Willoughby, OH 44094 Phone: 440-354-1899 Fax: 440-354-1089 | |
Willoughby Medical Offices Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 5105 Som Center Road, Willoughby, OH 44094 Phone: 216-265-8844 Fax: 216-265-8890 | |
Signature Health Medical Group, Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 38882 Mentor Ave, Willoughby, OH 44094 Phone: 440-953-9999 Fax: 440-918-3839 | |
Signature Health, Inc. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 38876 Mentor Avenue, Willoughby, OH 44094 Phone: 440-953-9999 Fax: 440-918-3839 |