Organization
ERIESIDE MEDICAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WINSTON HO M.D. (PRESIDENT)
(440) 269-7483
Entity
Organization
Contact information
Practice address
38429 LAKE SHORE BLVD, WILLOUGHBY, OH 44094-7009
(440) 946-9200
Mailing address
38429 LAKE SHORE BLVD, WILLOUGHBY, OH 44094-7009
(440) 946-9200
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
35-052285D
OH
207R00000X
Internal Medicine Physician
34-003413F
OH
207R00000X
Internal Medicine Physician
35-06-5285H
OH
2080A0000X
Pediatric Adolescent Medicine Physician
35-06-1390M
—
Other
Enumeration date
04/21/2006
Last updated
06/10/2010
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