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Individual

THOR TANGVALD IV

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
3200 BURNET AVE, CINCINNATI, OH 45229-3019
(513) 558-7700
(513) 558-5055
Mailing address
PO BOX 636256, CINCINNATI, OH 45263-6256
(513) 585-6200
(513) 245-3672

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
25MA11553500
NJ
2084P0800X
Psychiatry Physician
33141
KY
2084P0800X
Psychiatry Physician
35.059078
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
64938137
KY
Enumeration date
01/08/2007
Last updated
02/03/2026
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