IndividualActive
Theodore Lange, MD
NPI 1831119270 · Pulmonary Disease Physician · Boise, ID
Provider details
- NPI number
- 1831119270
- Entity type
- Individual
- Primary specialty
- Pulmonary Disease PhysicianAllopathic & Osteopathic Physicians
- Credential
- MD
- Sex
- Male
- Sole proprietor
- No
- License
- M-9049 (ID)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Practice location
500 W Fort St.
# 111
Boise, ID 83702
Phone: (208) 422-1325
Fax: (208) 422-1319
Approximate (ZIP-level) locationGet directions
Mailing address
500 W Fort St.
Boise, ID 83702
Registry dates
- Enumerated
- 2006-07-20
- Last updated
- 2022-04-19
- Certified
- 2022-04-19
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.