MEDICARE: DR. DOUGLAS R ANGERMAN M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	35032500	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1356351803
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DOUGLAS R ANGERMAN M.D.

Provider Business Mailing Address
First Line	:	PO BOX 74006
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44191-0001
Country	:	US
Telephone Number	:	216-383-6776
Fax Number	:	216-383-6475

Provider Business Practice Location Address
First Line	:	167 W MAIN RD
Second Line	:	SUITE F
City	:	CONNEAUT
State	:	OH
Zip	:	44030-2057
Country	:	US
Telephone Number	:	440-599-7466
Fax Number	:	440-593-6498

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/08/2006
Last Update Date	:	12/19/2007

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