Individual
DR. EDWIN L DELANGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O. PC
Contact information
Practice address
3273 DAVISON RD, STE 2, LAPEER, MI 48446-2902
(810) 667-8840
(810) 667-8846
Mailing address
1461 BALDWIN RD, LAPEER, MI 48446-9776
(810) 667-2923
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
ED008382
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
30-0010621
STATE LICENSE NUMBER
MI
01
—
5440014
BCBS PIN #
MI
Enumeration date
07/07/2005
Last updated
01/12/2012
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