Healthcare Provider Details

I. General information

NPI: 1609835313
Provider Name (Legal Business Name): PAUL A LANGE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/21/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1535 GULL RD STE 130
KALAMAZOO MI
49048
US

IV. Provider business mailing address

1535 GULL RD STE 130
KALAMAZOO MI
49048
US

V. Phone/Fax

Practice location:
  • Phone: 269-345-1161
  • Fax: 269-345-8076
Mailing address:
  • Phone: 269-345-1161
  • Fax: 269-345-8076

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License NumberPL054832
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License NumberPL054832
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: