Provider Demographics
NPI:1396783254
Name:PSARRAS, JAMES P (MD)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:P
Last Name:PSARRAS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:29425 CHAGRIN BLVD
Mailing Address - Street 2:SUITE 301
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44122-4639
Mailing Address - Country:US
Mailing Address - Phone:330-758-4515
Mailing Address - Fax:330-758-5121
Practice Address - Street 1:29425 CHAGRIN BLVD
Practice Address - Street 2:SUITE 301
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44122-4639
Practice Address - Country:US
Practice Address - Phone:330-758-4515
Practice Address - Fax:330-758-5121
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-03
Last Update Date:2018-11-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OH35.0458192084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0479192Medicaid
0520341Medicare PIN
A80463Medicare UPIN