Organization
NORTH SHORE ANESTHESIA LIMITED, LLC
Active
Organization
NORTH SHORE ANESTHESIA LIMITED, LLC
Active
Parent organization
NORTH SHORE GASTROENTEROLOGY, INC
Organization subpart
Yes
Provider details
NPI number
Legal business name
NORTH SHORE GASTROENTEROLOGY, INC
Authorized official
DR. MOUSAB I TABBAA MD (PRESIDENT)
(440) 808-1212
Entity
Organization
Contact information
Practice address
850 COLUMBIA RD STE 200, WESTLAKE, OH 44145-7215
(440) 808-1212
(440) 808-2060
Mailing address
850 COLUMBIA RD, SUITE 200, WESTLAKE, OH 44145-1493
(440) 808-1212
(440) 808-0321
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0061881
—
OH
01
—
DS6414
MEDICARE RAILROAD
OH
Enumeration date
08/29/2011
Last updated
01/23/2024
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