Provider Demographics
NPI:1366512642
Name:TRANGLE, KEVIN L (MD)
Entity type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:L
Last Name:TRANGLE
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:3601 S GREEN ROAD
Mailing Address - Street 2:SUITE #314
Mailing Address - City:BEACHWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:44122
Mailing Address - Country:US
Mailing Address - Phone:216-504-0400
Mailing Address - Fax:216-504-0404
Practice Address - Street 1:3601 GREEN RD
Practice Address - Street 2:SUITE #314
Practice Address - City:BEACHWOOD
Practice Address - State:OH
Practice Address - Zip Code:44122-5725
Practice Address - Country:US
Practice Address - Phone:216-504-0400
Practice Address - Fax:216-504-0404
Is Sole Proprietor?:No
Enumeration Date:2006-11-08
Last Update Date:2018-10-25
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
OH01161340207RA0401X, 2083X0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational Medicine
No207RA0401XAllopathic & Osteopathic PhysiciansInternal MedicineAddiction Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH055028Medicaid
TR0788261Medicare ID - Type Unspecified
E33926Medicare UPIN