Provider Demographics
NPI:1932210929
Name:TANGEMAN, CAYCE C (MD)
Entity Type:Individual
Prefix:DR
First Name:CAYCE
Middle Name:C
Last Name:TANGEMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:PO BOX 751649
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28275-1649
Mailing Address - Country:US
Mailing Address - Phone:843-789-1620
Mailing Address - Fax:843-724-2440
Practice Address - Street 1:149 SAINT JAMES AVE
Practice Address - Street 2:
Practice Address - City:GOOSE CREEK
Practice Address - State:SC
Practice Address - Zip Code:29445-2923
Practice Address - Country:US
Practice Address - Phone:843-553-0526
Practice Address - Fax:843-553-4410
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2013-12-11
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
SC23268207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC232689Medicaid
SCI22668Medicare UPIN