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Organization

CHERRY WESTGATE FAMILY PRACTICE, INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. LORA ANN MEIKLE CMOM (OFFICE MANAGER)
(740) 587-0087
Entity
Organization

Contact information

Practice address
2000 NEWARK GRANVILLE RD, SUITE 100, GRANVILLE, OH 43023-9135
(740) 587-0087
(740) 587-0084
Mailing address
2000 NEWARK GRANVILLE RD, SUITE 100, GRANVILLE, OH 43023-9135
(740) 587-0087
(740) 587-0084

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0937071
OH
01
CG0047
RAILROAD MEDICARE
OH
Enumeration date
08/29/2005
Last updated
07/28/2017
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