# WESTSHORE PRIMARY CARE ASSOC., INC.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1013210079
- **Authorized official:** MISTY A BLAYLOCK (CREDENTIALING COORDINATOR)
- **Authorized official phone:** (440) 892-6406

## Contact information

- **Practice address:** 29325 HEALTH CAMPUS DR, SUITE 1, WESTLAKE, OH 44145-8201
- **Practice address phone:** (440) 835-6996
- **Practice address fax:** (440) 808-9738
- **Mailing address:** 26908 DETROIT RD, SUITE 301, WESTLAKE, OH 44145-2398
- **Mailing address phone:** (440) 617-1823
- **Mailing address fax:** (440) 617-0884

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207V00000X | Obstetrics & Gynecology Physician | — | NULL | Yes |
| 207V00000X | Obstetrics & Gynecology Physician | — | — | Yes |

## Other

- **Enumeration date:** 12/14/2010
- **Last updated:** 12/14/2010