Individual
MARSHA M LANGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
607 DEMERS AVE, EAST GRAND FORKS, MN 56721-1833
(218) 773-0357
(218) 773-2994
Mailing address
2401 DEMERS AVE, GRAND FORKS, ND 58201
(701) 780-1891
(701) 587-6009
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
52278
MN
207Q00000X
Family Medicine Physician
5823
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5823
NORTH DAKOTA STATE MEDICAL LICENSE
ND
Enumeration date
07/18/2006
Last updated
07/31/2019
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