Provider Demographics
NPI:1730317264
Name:ANGELOS, TYLER M (MD)
Entity Type:Individual
Prefix:
First Name:TYLER
Middle Name:M
Last Name:ANGELOS
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 1:5005 ARLINGTON CENTRE BLVD
Mailing Address - Street 2:
Mailing Address - City:UPPER ARLINGTON
Mailing Address - State:OH
Mailing Address - Zip Code:43220-2912
Mailing Address - Country:US
Mailing Address - Phone:614-246-6900
Mailing Address - Fax:614-246-6909
Practice Address - Street 1:5005 ARLINGTON CENTRE BLVD
Practice Address - Street 2:
Practice Address - City:UPPER ARLINGTON
Practice Address - State:OH
Practice Address - Zip Code:43220-2912
Practice Address - Country:US
Practice Address - Phone:614-246-6900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-06-23
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.125866208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery