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General NPI Number Information
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NPI Number | 1699959619
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Entity Type | Organization
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Legal Business Name | DONALD H. LANGE MD
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Dates
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Enumeration Date | 12/27/2007
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Last Update Date | 12/27/2007
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Provider Practice Location Address
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Address Line | 5000 CEDAR PLAZA PKWY SUITE 230
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City | SAINT LOUIS
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State | MO
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Zip | 63128-3854
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Country | US
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Telephone | 314-849-7372
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Fax |
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Provider Business Mailing Address
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Address Line | 5000 CEDAR PLAZA PKWY SUITE 230
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City | SAINT LOUIS
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State | MO
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Zip | 63128-3854
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Country | US
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Telephone | 314-849-7372
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Fax |
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Authorized Official
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Title or Position | SOLE PROPRIETOR
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Name | DONALD H LANGE
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Credential | MD
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Telephone | 314-849-7372
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | R1B73
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License Number State | MO
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