Organization
OUTREACH PROFESSIONAL SERVICES INC
Active
Other names
Cuyahoga Physician Network
Organization subpart
No
Provider details
NPI number
Authorized official
MISTY A BLAYLOCK (CREDENTIALING COORDINATOR)
(440) 892-6406
Entity
Organization
Contact information
Practice address
29099 HEALTH CAMPUS DR, SUITE 380, WESTLAKE, OH 44145
(440) 827-5390
(440) 827-5344
Mailing address
26908 DETROIT RD, SUITE 301, WESTLAKE, OH 44145-2398
(440) 617-1823
(440) 617-0884
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0251856
—
OH
Enumeration date
12/04/2007
Last updated
01/12/2010
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