West Side Cardiothoracic Surgeons, Inc.

Primary specialty

Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X

Legal business name

WEST SIDE CARDIOTHORACIC SURGEONS, INC.

Practice address

15644 Madison Ave
Suite #202
Lakewood, OH 44107-5622

Phone

(216) 521-3384

Fax

(216) 521-3385

NPI assigned

Aug 9, 2005

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. M. Hani Khaddam, M.D.

Title

President

Phone

(216) 521-3384

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1123545600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1679574156",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 567",
            "city": "CHAGRIN FALLS",
            "state": "OH",
            "postal_code": "440220567",
            "telephone_number": "216-464-5160",
            "fax_number": "216-464-5982"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15644 MADISON AVE",
            "address_2": "SUITE #202",
            "city": "LAKEWOOD",
            "state": "OH",
            "postal_code": "441075622",
            "telephone_number": "216-521-3384",
            "fax_number": "216-521-3385"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEST SIDE CARDIOTHORACIC SURGEONS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-09",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "KHADDAM",
        "authorized_official_first_name": "M.",
        "authorized_official_middle_name": "HANI",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "216-521-3384",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208G00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "OH",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician in Lakewood, OH
• Providers in Lakewood, OH by specialty
• Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.