Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RA0401X | Internist - Addiction Medicine | 01161340 | OH |
NPI | 1366512642 |
---|---|
Provider Name | Dr. Kevin L Trangle |
First Address | Beachwood, OH 44122 |
Second Address | Beachwood, OH 44122-5725 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/11/2006 |
Last Update Date | 25/10/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
055028 | (05) | OH |
E33926 | (02) |