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Individual

DR. STEPHEN GLOVER LANG

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
555 WEST WACKERLY STREET, SUITE 3500, MIDLAND, MI 48640-4713
(989) 839-1234
(989) 839-7090
Mailing address
555 WEST WACKERLY STREET, SUITE 3500, MIDLAND, MI 48640-4713
(989) 839-1234
(989) 839-7090

Taxonomy

Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
4301401783
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0705600882
BLUECROSSBLUESHIELD
01
G36801
CONNECTCAREAETNA PPO DOW
Enumeration date
09/01/2006
Last updated
07/18/2007
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