Provider Demographics
NPI:1649454208
Name:WESTSIDE MEDICAL ASSOCIATES PA
Entity type:Organization
Organization Name:WESTSIDE MEDICAL ASSOCIATES PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MALCOLM
Authorized Official - Middle Name:M
Authorized Official - Last Name:MAJOR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:954-474-3010
Mailing Address - Street 1:301 NW 84TH AVE
Mailing Address - Street 2:SUITE 201
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33324-1807
Mailing Address - Country:US
Mailing Address - Phone:954-474-3010
Mailing Address - Fax:954-474-2129
Practice Address - Street 1:301 NW 84TH AVE
Practice Address - Street 2:SUITE 201
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33324-1807
Practice Address - Country:US
Practice Address - Phone:954-474-3010
Practice Address - Fax:954-474-2129
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-19
Last Update Date:2007-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0055747207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty