Individual
PAUL THEODORE OMELSKY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2460 FAIRMOUNT BLVD, SIUTE 212, CLEVELAND HTS, OH 44106-3171
(216) 536-8479
(216) 932-7668
Mailing address
2460 FAIRMOUNT BLVD, SUITE 212, CLEVELAND HTS, OH 44106-3171
(216) 536-8479
(216) 932-7668
Taxonomy
Speciality
Code
Description
License number
State
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
35.031025
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0150223
—
OH
Enumeration date
12/21/2006
Last updated
11/12/2009
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