| Outreach Professional Services Inc | |
| 2322 East 22nd St Suite 207 Cleveland PA 44145 | |
| (216) 592-2801 | |
| (216) 592-2811 | 
| Full Name | Outreach Professional Services Inc | 
|---|---|
| Speciality | Surgery | 
| Location | 2322 East 22nd St, Cleveland, Pennsylvania | 
| Authorized Official Name and Position | Misty A Blaylock (CREDENTIALING COORDINATOR) | 
| Authorized Official Contact | 4408926406 | 
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. | 
| Mailing Address | Practice Location Address | 
|---|---|
| Outreach Professional Services Inc 26908 Detroit Rd Suite 301 Westlake OH 44145-2398 Ph: (440) 617-1823 | Outreach Professional Services Inc 2322 East 22nd St Suite 207 Cleveland PA 44145 Ph: (216) 592-2801 | 
| NPI Number | 1780866467 | 
|---|---|
| Provider Enumeration Date | 12/04/2007 | 
| Last Update Date | 01/12/2010 | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1780866467 | NPI | - | NPPES | 
| 0251856 | Medicaid | OH | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Secondary | 
| 208600000X | Surgery | (* (Not Available)) | Primary |