# WEST SIDE CARDIOTHORACIC SURGEONS, INC.

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

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

## Provider details

- **NPI number:** 1679574156
- **Authorized official:** DR. M. HANI KHADDAM M.D. (PRESIDENT)
- **Authorized official phone:** (216) 521-3384

## Contact information

- **Practice address:** 15644 MADISON AVE, SUITE \#202, LAKEWOOD, OH 44107-5622
- **Practice address phone:** (216) 521-3384
- **Practice address fax:** (216) 521-3385
- **Mailing address:** PO BOX 567, CHAGRIN FALLS, OH 44022-0567
- **Mailing address phone:** (216) 464-5160
- **Mailing address fax:** (216) 464-5982

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208G00000X | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician | — | OH | Yes |

## Other

- **Enumeration date:** 08/09/2005
- **Last updated:** 07/21/2022