# ID CARE PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1669656112
- **Authorized official:** KALYANI VANGALA M.D. (PRESIDENT)
- **Authorized official phone:** (517) 364-5590

## Contact information

- **Practice address:** 1808 S PENNSYLVANIA AVE, SUITE E, LANSING, MI 48910-1897
- **Practice address phone:** (517) 371-1500
- **Practice address fax:** (517) 371-1501
- **Mailing address:** 1800 BRAMBLE DR, EAST LANSING, MI 48823-1730
- **Mailing address phone:** (517) 364-5590

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207RI0200X | Infectious Disease Physician | — | NULL | Yes |
| 207RI0200X | Infectious Disease Physician | — | — | Yes |

## Other

- **Enumeration date:** 12/19/2007
- **Last updated:** 09/11/2008