Individual
CHARLES LANGDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2332 ALPINE AVE NW, GRAND RAPIDS, MI 49544-1955
(616) 391-2503
(616) 391-6219
Mailing address
100 MICHIGAN ST NE, MC845, GRAND RAPIDS, MI 49503-2560
(616) 391-2503
(616) 391-6219
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
4301041022
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1104128161
BCBS
MI
01
—
1598712390
GROUP NPI
MI
05
—
4770914
—
MI
05
—
4770960
—
MI
05
—
4771125
—
MI
05
—
4773765
—
MI
05
—
4774010
—
MI
Enumeration date
05/05/2006
Last updated
11/19/2012
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