Provider Demographics
NPI:1669286712
Name:TANGHE, MARCUS D (RDN)
Entity type:Individual
Prefix:
First Name:MARCUS
Middle Name:D
Last Name:TANGHE
Suffix:
Gender:M
Credentials:RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:68 STATE PARK DR
Mailing Address - Street 2:
Mailing Address - City:BAY CITY
Mailing Address - State:MI
Mailing Address - Zip Code:48706-2142
Mailing Address - Country:US
Mailing Address - Phone:989-600-2740
Mailing Address - Fax:
Practice Address - Street 1:68 STATE PARK DR
Practice Address - Street 2:
Practice Address - City:BAY CITY
Practice Address - State:MI
Practice Address - Zip Code:48706-2142
Practice Address - Country:US
Practice Address - Phone:989-600-2740
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-06
Last Update Date:2025-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered