Organization
NORTH SHORE GASTROENTEROLOGY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
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) 808-0321
Mailing address
850 COLUMBIA RD STE 200, WESTLAKE, OH 44145-7215
(440) 808-1212
(440) 808-0321
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
—
—
207RI0008X
Hepatology Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0727897
—
OH
01
—
CL6884
RAILROAD MEDICARE
OH
Enumeration date
07/25/2006
Last updated
05/27/2025
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