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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
15900 SNOW RD, SUITE 200, BROOK PARK, OH 44142
(216) 676-1234
(216) 676-5876
Mailing address
26908 DETROIT RD, SUITE 301, WESTLAKE, OH 44145-2398
(440) 617-1823
(440) 617-0884

Taxonomy

Speciality
Code
Description
License number
State
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
207L00000X
Anesthesiology Physician
207Q00000X
Family Medicine Physician
207R00000X
Internal Medicine Physician
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
207RP1001X
Pulmonary Disease Physician
207T00000X
Neurological Surgery Physician
207V00000X
Obstetrics & Gynecology Physician
207X00000X
Orthopaedic Surgery Physician
Primary
2084N0400X
Neurology Physician
2084P0800X
Psychiatry Physician
208600000X
Surgery Physician
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
213E00000X
Podiatrist
367A00000X
Advanced Practice Midwife

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0251856
OH
Enumeration date
11/14/2007
Last updated
01/12/2010
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