Provider Demographics
NPI:1982603643
Name:ORTHOWEST LTD
Entity Type:Organization
Organization Name:ORTHOWEST LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:ALAN
Authorized Official - Last Name:BANKS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:440-816-5380
Mailing Address - Street 1:7255 OLD OAK BLVD
Mailing Address - Street 2:C405
Mailing Address - City:MIDDLEBURG HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44130-3329
Mailing Address - Country:US
Mailing Address - Phone:440-816-5380
Mailing Address - Fax:440-816-5398
Practice Address - Street 1:7255 OLD OAK BLVD
Practice Address - Street 2:C405
Practice Address - City:MIDDLEBURG HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44130-3331
Practice Address - Country:US
Practice Address - Phone:440-816-5380
Practice Address - Fax:440-816-5398
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-15
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH207X00000X
OH4648210001332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical SuppliesGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2287181Medicaid
OHCJ5824OtherRRMEDICARE GROUPID
OH4648210001Medicare NSC
OHCJ5824OtherRRMEDICARE GROUPID