Organization
ID CARE PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KALYANI VANGALA M.D. (PRESIDENT)
(517) 364-5590
Entity
Organization
Contact information
Practice address
1808 S PENNSYLVANIA AVE, SUITE E, LANSING, MI 48910-1897
(517) 371-1500
(517) 371-1501
Mailing address
1800 BRAMBLE DR, EAST LANSING, MI 48823-1730
(517) 364-5590
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
110C315710
BCBSM
—
Enumeration date
12/19/2007
Last updated
09/11/2008
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