Provider Demographics
NPI:1104887959
Name:WESTSIDE MEDICINE & CARDIOLOGY INC
Entity type:Organization
Organization Name:WESTSIDE MEDICINE & CARDIOLOGY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:AZMAT
Authorized Official - Middle Name:
Authorized Official - Last Name:HUSSAIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:440-925-7000
Mailing Address - Street 1:29099 HEALTH CAMPUS DR.
Mailing Address - Street 2:SUITE 150, BUILDING 3
Mailing Address - City:WESTLAKE
Mailing Address - State:OH
Mailing Address - Zip Code:44145
Mailing Address - Country:US
Mailing Address - Phone:440-925-7000
Mailing Address - Fax:440-925-7001
Practice Address - Street 1:29099 HEALTH CAMPUS DR
Practice Address - Street 2:BLDG 3, SUITE 150
Practice Address - City:WESTLAKE
Practice Address - State:OH
Practice Address - Zip Code:44145
Practice Address - Country:US
Practice Address - Phone:440-925-7000
Practice Address - Fax:440-925-7001
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-31
Last Update Date:2023-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH201769OtherFEDERAL BLACK LUNG
OH2178174Medicaid
OH1535055OtherUNITED MINE WORKERS
OH1535055OtherUNITED MINE WORKERS
OH2178174Medicaid
OHCG4308Medicare ID - Type UnspecifiedRAILROAD
OH=========00OtherWORKERS COMP