Healthcare Provider Details

I. General information

NPI: 1891787479
Provider Name (Legal Business Name): MARLYS R DRANGE MD,PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/18/2005
Last Update Date: 05/02/2025
Certification Date: 05/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2550 E BROADWAY ST
HELENA MT
59601-4905
US

IV. Provider business mailing address

2029 VERDUGO BLVD # 781
MONTROSE CA
91020-1626
US

V. Phone/Fax

Practice location:
  • Phone: 406-457-4180
  • Fax:
Mailing address:
  • Phone: 626-795-2663
  • Fax: 973-425-5657

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License NumberA54654
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: