Provider Demographics
NPI:1346327715
Name:TSANGALIAS, STEVE S (MD)
Entity Type:Individual
Prefix:DR
First Name:STEVE
Middle Name:S
Last Name:TSANGALIAS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6151 GULF OF MEXICO DR
Mailing Address - Street 2:
Mailing Address - City:LONGBOAT KEY
Mailing Address - State:FL
Mailing Address - Zip Code:34228-1508
Mailing Address - Country:US
Mailing Address - Phone:313-350-3235
Mailing Address - Fax:
Practice Address - Street 1:63 KERCHEVAL AVE
Practice Address - Street 2:SUITE 202
Practice Address - City:GROSSE POINTE FARMS
Practice Address - State:MI
Practice Address - Zip Code:48236-3639
Practice Address - Country:US
Practice Address - Phone:313-886-6900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIST0296342082S0105X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2082S0105XAllopathic & Osteopathic PhysiciansPlastic SurgerySurgery of the Hand
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1160116Medicaid
MI0M20380Medicare ID - Type Unspecified
MI1160116Medicaid