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Organization
WESTSHORE ADVANCED MEDICINE INC
Active
Organization
WESTSHORE ADVANCED MEDICINE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MOHAMMAD REZA MD (PRESIDENT)
(440) 333-5767
Entity
Organization
Contact information
Practice address
20455 LORAIN RD, SUITE T04, FAIRVIEW PARK, OH 44126-3494
(440) 333-5767
(440) 333-5768
Mailing address
PO BOX 450923, WESTLAKE, OH 44145-0621
(440) 274-5035
(440) 260-6153
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3076406
—
OH
Enumeration date
03/29/2006
Last updated
06/29/2011
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