Most Relevant Information
Provider Data
| NPI Number: | 1003503186 |
| Provider Name: | MICHAEL LANGE |
| Entity Type: | Individual |
| Taxonomy Code: | 390200000X |
| Specialty: | Student in an Organized Health Care Education/Training Program |
| License Number: |
Most Important Dates
| Enumeration Date: | 04/19/2023 |
| Last Updated: | 06/28/2024 |
Provider Practice Location
1130 W. MICHIGAN STREET
FESLER HALL 204
INDIANAPOLIS
IN
46202
Practice Location Phone/Fax
| Phone: | 3172740275 |
| Fax: |
Provider Mailing Location
1130 W. MICHIGAN STREET
FESLER HALL 204
INDIANAPOLIS
IN
46202
Provider Mailing Phone/Fax
| Phone: | 3172740275 |
| Fax: |