Provider Demographics
NPI:1356703821
Name:GANG, ANJULIE (MD)
Entity type:Individual
Prefix:
First Name:ANJULIE
Middle Name:
Last Name:GANG
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:2001 COOLIDGE RD
Mailing Address - Street 2:
Mailing Address - City:EAST LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48823-1378
Mailing Address - Country:US
Mailing Address - Phone:517-337-1668
Mailing Address - Fax:517-337-1779
Practice Address - Street 1:2790 W GRAND RIVER AVE STE 200
Practice Address - Street 2:
Practice Address - City:HOWELL
Practice Address - State:MI
Practice Address - Zip Code:48843-8424
Practice Address - Country:US
Practice Address - Phone:517-548-3571
Practice Address - Fax:517-545-2543
Is Sole Proprietor?:No
Enumeration Date:2016-03-24
Last Update Date:2025-11-14
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MI4301515686207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1356703821Medicaid