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Organization

WEST SIDE CARDIOTHORACIC SURGEONS, INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. M. HANI KHADDAM M.D. (PRESIDENT)
(216) 521-3384
Entity
Organization

Contact information

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

Taxonomy

Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
OH

Other

Enumeration date
08/09/2005
Last updated
07/21/2022
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