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General NPI Number Information
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NPI Number | 1376650606
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Entity Type | Organization
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Legal Business Name | WESTSIDE HEMATOLOGY ONCOLOGY INC
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Dates
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Enumeration Date | 08/24/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 29101 HEALTH CAMPUS DR STE 260
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City | WESTLAKE
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State | OH
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Zip | 44145-5266
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Country | US
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Telephone | 440-808-6500
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Fax | 440-808-8865
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Provider Business Mailing Address
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Address Line | 29101 HEALTH CAMPUS DR STE 260
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City | WESTLAKE
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State | OH
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Zip | 44145-5266
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Country | US
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Telephone | 440-808-6500
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Fax | 440-808-8865
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MARWAN MASSOUH
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Credential | MD
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Telephone | 440-808-6500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number | 35056179M
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License Number State | OH
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