| Outreach Professional Services Inc | |
|
26908 Detroit Rd Suite 200 Westlake OH 44414 | |
| (440) 871-6060 | |
| (440) 871-6726 |
| Full Name | Outreach Professional Services Inc |
|---|---|
| Speciality | Internal Medicine |
| Location | 26908 Detroit Rd, Westlake, Ohio |
| 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 26908 Detroit Rd Suite 200 Westlake OH 44414 Ph: (440) 871-6060 |
| NPI Number | 1285816959 |
|---|---|
| Provider Enumeration Date | 12/04/2007 |
| Last Update Date | 01/12/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285816959 | NPI | - | NPPES |
| 0251856 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| 207RR0500X | Internal Medicine - Rheumatology | (* (Not Available)) | Secondary |
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