Provider Demographics
NPI:1528160793
Name:TSAI, A ROGER (MD FACC)
Entity type:Individual
Prefix:
First Name:A
Middle Name:ROGER
Last Name:TSAI
Suffix:
Gender:M
Credentials:MD FACC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:6847 N CHESTNUT ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:RAVENNA
Mailing Address - State:OH
Mailing Address - Zip Code:44266-3929
Mailing Address - Country:US
Mailing Address - Phone:330-297-6110
Mailing Address - Fax:330-296-0592
Practice Address - Street 1:6847 N CHESTNUT ST
Practice Address - Street 2:SUITE 100
Practice Address - City:RAVENNA
Practice Address - State:OH
Practice Address - Zip Code:44266-3929
Practice Address - Country:US
Practice Address - Phone:330-297-6110
Practice Address - Fax:330-296-0592
Is Sole Proprietor?:No
Enumeration Date:2006-09-01
Last Update Date:2020-12-22
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
OH35041278207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0501415Medicaid
OH0501415Medicaid
OH4231911Medicare PIN