Provider Demographics
NPI:1730167248
Name:DESGRANGES, LOUISE (MD)
Entity type:Individual
Prefix:
First Name:LOUISE
Middle Name:
Last Name:DESGRANGES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:G 8145 S SAGINAW STREET
Mailing Address - Street 2:SUITE C
Mailing Address - City:GRAND BLANC
Mailing Address - State:MI
Mailing Address - Zip Code:48439
Mailing Address - Country:US
Mailing Address - Phone:810-694-2730
Mailing Address - Fax:810-694-2731
Practice Address - Street 1:G 8145 S SAGINAW STREET
Practice Address - Street 2:SUITE C
Practice Address - City:GRAND BLANC
Practice Address - State:MI
Practice Address - Zip Code:48439
Practice Address - Country:US
Practice Address - Phone:810-694-2730
Practice Address - Fax:810-694-2731
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MILD339592084P0804X, 2084P0805X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
Not Answered2084P0805XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyGeriatric Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI2605512OtherHEALTHPLUS OF MICHIGAN
MI1301985Medicaid
P73919OtherBLUE CARE NETWORK
MI1301985Medicaid