| Edwin L Delange, DO PC | |
|
3273 Davison Rd Suite #2 Lapeer MI 48446-2902 | |
| (810) 667-8840 | |
| Not Available |
| Full Name | Edwin L Delange, DO PC |
|---|---|
| Speciality | Clinic/Center |
| Location | 3273 Davison Rd, Lapeer, Michigan |
| Authorized Official Name and Position | Edwin Lee Delange DO PC (PHYSICIAN) |
| Authorized Official Contact | 8106678840 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Edwin L Delange, DO PC 3273 Davison Rd Suite #2 Lapeer MI 48446-2902 Ph: (810) 667-8840 | Edwin L Delange, DO PC 3273 Davison Rd Suite #2 Lapeer MI 48446-2902 Ph: (810) 667-8840 |
| NPI Number | 1821394297 |
|---|---|
| Provider Enumeration Date | 02/02/2011 |
| Last Update Date | 04/18/2011 |
| Medicare PECOS PAC ID | 3779764543 |
|---|---|
| Medicare Enrollment ID | O20110228000196 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821394297 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 5101008382 (Michigan) | Primary |
| Provider Name | Edwin L Delange |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1073510723 PECOS PAC ID: 4688855455 Enrollment ID: I20111229000119 |
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