Provider Demographics
NPI:1538625439
Name:WESTSIDE WOMENS MEDICINE
Entity type:Organization
Organization Name:WESTSIDE WOMENS MEDICINE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EMPLOYEE
Authorized Official - Prefix:
Authorized Official - First Name:REGINA
Authorized Official - Middle Name:
Authorized Official - Last Name:HILL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:440-250-0696
Mailing Address - Street 1:PO BOX 45006
Mailing Address - Street 2:
Mailing Address - City:WESTLAKE
Mailing Address - State:OH
Mailing Address - Zip Code:44145-0006
Mailing Address - Country:US
Mailing Address - Phone:440-250-0696
Mailing Address - Fax:440-250-1857
Practice Address - Street 1:805 COLUMBIA RD STE 105
Practice Address - Street 2:
Practice Address - City:WESTLAKE
Practice Address - State:OH
Practice Address - Zip Code:44145-1461
Practice Address - Country:US
Practice Address - Phone:440-250-0696
Practice Address - Fax:440-250-1857
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-15
Last Update Date:2022-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Multi-Specialty