| Westshore Primary Care Assoc., Inc. | |
|
20455 Lorain Rd Suite 102 Fairview Park OH 44126-3494 | |
| (440) 353-5477 | |
| (440) 356-5885 |
| Full Name | Westshore Primary Care Assoc., Inc. |
|---|---|
| Speciality | Family Medicine |
| Location | 20455 Lorain Rd, Fairview Park, Ohio |
| Authorized Official Name and Position | Misty Blaylock (CREDENTIALING COORDINATOR) |
| Authorized Official Contact | 4408926406 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Westshore Primary Care Assoc., Inc. 26908 Detroit Rd Suite 301 Westlake OH 44145-2398 Ph: (440) 617-1823 | Westshore Primary Care Assoc., Inc. 20455 Lorain Rd Suite 102 Fairview Park OH 44126-3494 Ph: (440) 353-5477 |
| NPI Number | 1023359023 |
|---|---|
| Provider Enumeration Date | 03/15/2013 |
| Last Update Date | 03/15/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023359023 | NPI | - | NPPES |
| 0858077 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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