Organization
OUTREACH PROFESSIONAL SERVICES INC
Active
Other names
St Vincent Medical Group
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN RUSNACZYK (SENIOR VICE PRESIDENT & CFO)
(216) 363-7718
Entity
Organization
Contact information
Practice address
2351 E 22ND ST, CLEVELAND, OH 44115-3111
(216) 363-2730
Mailing address
PO BOX 932127, CLEVELAND, OH 44193-0008
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207QG0300X
Geriatric Medicine (Family Medicine) Physician
—
—
207R00000X
Internal Medicine Physician
Primary
—
—
207RR0500X
Rheumatology Physician
—
—
207RX0202X
Medical Oncology Physician
—
—
207V00000X
Obstetrics & Gynecology Physician
—
—
207X00000X
Orthopaedic Surgery Physician
—
—
208000000X
Pediatrics Physician
—
—
2084P0800X
Psychiatry Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0251856
—
OH
Enumeration date
10/25/2005
Last updated
01/13/2021
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