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General NPI Number Information
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NPI Number | 1336344746
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Entity Type | Individual
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Provider Name | CHRISTOPHER TANGEN D.O.
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Gender | Male
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Dates
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Enumeration Date | 06/15/2007
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Last Update Date | 10/28/2025
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Provider Practice Location Address
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Address Line | 1611 S GREEN RD STE 160
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City | SOUTH EUCLID
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State | OH
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Zip | 44121-6100
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Country | US
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Telephone | 440-585-7146
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Fax | 440-585-7041
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Provider Business Mailing Address
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Address Line | PO BOX 8792
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City | BELFAST
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State | ME
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Zip | 04915-8792
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Country | US
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Telephone | 440-585-7146
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Fax | 440-585-7041
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207QS0010X
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Taxonomy Name | Sports Medicine (Family Medicine) Physician
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License Number | 35-009402
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 58.001840
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License Number State | OH
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