Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0120X | Pediatric Surgery | 0101250855 | VA |
N | 2086S0120X | Pediatric Surgery | 9901564 | NC |
NPI | 1295829125 |
---|---|
Provider Name | Dr. Patricia A Lange |
First Address | Richmond, VA 23291-1734 |
Second Address | Richmond, VA 23298-0510 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/10/2006 |
Last Update Date | 15/12/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
5901539 | (05) | NC |