Basic Information
| Provider Information | |||||||||
| NPI: | 1023077617 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | WEST | ||||||||
| FirstName: | JOYCE | ||||||||
| MiddleName: | ARLENE | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 125 PELRET PKWY | ||||||||
| Address2: | SUITE 200 | ||||||||
| City: | BEREA | ||||||||
| State: | OH | ||||||||
| PostalCode: | 44017 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4402745000 | ||||||||
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| Practice Location | |||||||||
| Address1: | 36000 EUCLID AVE | ||||||||
| Address2: | |||||||||
| City: | WILLOUGHBY | ||||||||
| State: | OH | ||||||||
| PostalCode: | 440944625 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4403544208 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/21/2006 | ||||||||
| LastUpdateDate: | 05/15/2008 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207ZP0102X | 35-029467 | OH | Y | Allopathic & Osteopathic Physicians | Pathology | Anatomic Pathology & Clinical Pathology |
ID Information
| ID | Type | State | Issuer | Description | 000000126683 | 01 | ANTHEM BLUE CROSS BLUE SHIELD | OTHER | 4015184 | 01 | AETNA | OTHER | 0821187 | 05 | OH | MEDICAID | 1100273 | 01 | UNITED HEALTH CARE | OTHER | 353945 | 01 | WELLCARE | OTHER |