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Organization

LEROY LANG JR MD PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
LEROY LANG JR. MD (OWNER)
(313) 861-4200
Entity
Organization

Contact information

Practice address
6001 W OUTER DR, SUITE 430, DETROIT, MI 48235-2614
(313) 861-4200
(313) 861-8981
Mailing address
6001 W OUTER DR, SUITE 430, DETROIT, MI 48235-2614
(313) 861-4200
(313) 861-8981

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
LL045267
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1108216092
BCBS PIN
MI
01
1184750101
MEDICAI
MI
Enumeration date
04/25/2008
Last updated
04/25/2008
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