Healthcare Provider Details

I. General information

NPI: 1336573393
Provider Name (Legal Business Name): MERCY HEALTH WESTSHORE CARDIOLOGY SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/27/2013
Last Update Date: 03/05/2026
Certification Date: 03/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1223 MERCY DR
MUSKEGON MI
49444-1829
US

IV. Provider business mailing address

1212 E SHERMAN BLVD
MUSKEGON MI
49444-1879
US

V. Phone/Fax

Practice location:
  • Phone: 231-672-3500
  • Fax: 231-672-6199
Mailing address:
  • Phone: 231-672-3500
  • Fax: 231-672-6199

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207RC0001X
TaxonomyClinical Cardiac Electrophysiology Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name: MICHAEL PAUL GUSHO
Title or Position: CHIEF FINANCIAL OFFICER
Credential:
Phone: 734-398-0642