| Id Care Pc | |
|
1808 S Pennsylvania Ave Suite E Lansing MI 48910-1897 | |
| (517) 371-1500 | |
| (517) 371-1501 |
| Full Name | Id Care Pc |
|---|---|
| Speciality | Internal Medicine - Infectious Disease |
| Location | 1808 S Pennsylvania Ave, Lansing, Michigan |
| Authorized Official Name and Position | Kalyani Vangala (PRESIDENT) |
| Authorized Official Contact | 5173645590 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Id Care Pc 1800 Bramble Dr East Lansing MI 48823-1730 Ph: (517) 364-5590 | Id Care Pc 1808 S Pennsylvania Ave Suite E Lansing MI 48910-1897 Ph: (517) 371-1500 |
| NPI Number | 1669656112 |
|---|---|
| Provider Enumeration Date | 12/19/2007 |
| Last Update Date | 09/11/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669656112 | NPI | - | NPPES |
| 110C315710 | Other | BCBSM |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RI0200X | Internal Medicine - Infectious Disease | (* (Not Available)) | Primary |
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