Provider Demographics
NPI:1699959619
Name:DONALD H. LANGE MD
Entity type:Organization
Organization Name:DONALD H. LANGE MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE PROPRIETOR
Authorized Official - Prefix:
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:H
Authorized Official - Last Name:LANGE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:314-849-7372
Mailing Address - Street 1:5000 CEDAR PLAZA PKWY
Mailing Address - Street 2:SUITE 230
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63128-3854
Mailing Address - Country:US
Mailing Address - Phone:314-849-7372
Mailing Address - Fax:
Practice Address - Street 1:5000 CEDAR PLAZA PKWY
Practice Address - Street 2:SUITE 230
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63128-3854
Practice Address - Country:US
Practice Address - Phone:314-849-7372
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-27
Last Update Date:2007-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOR1B73207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty