Provider Demographics
NPI:1043470339
Name:DR. DARLYNE CANGE,DPM,LLC
Entity Type:Organization
Organization Name:DR. DARLYNE CANGE,DPM,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR PODIATRIC MEDICINE
Authorized Official - Prefix:DR
Authorized Official - First Name:DARLYNE
Authorized Official - Middle Name:
Authorized Official - Last Name:CANGE
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:410-733-4770
Mailing Address - Street 1:PO BOX 1606
Mailing Address - Street 2:
Mailing Address - City:ELLICOTT CITY
Mailing Address - State:MD
Mailing Address - Zip Code:21041-1606
Mailing Address - Country:US
Mailing Address - Phone:410-733-4770
Mailing Address - Fax:
Practice Address - Street 1:7310 RITCHIE HWY STE 404
Practice Address - Street 2:
Practice Address - City:GLEN BURNIE
Practice Address - State:MD
Practice Address - Zip Code:21061-3082
Practice Address - Country:US
Practice Address - Phone:410-766-1444
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-11
Last Update Date:2021-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD01457213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD201922OtherJOHN HOPKINS/PRIORITY PARTNERS/UNIFORMED SERVICES FAMILY HEALTH/EMPLOYER HEALTH
MD7278OtherBRAVO/ELDER HEALTH
MD018750060OtherMARYLAND PHYSICIAN CARE
MDP00645864 AND DN9160OtherRAILROAD MEDICARE
MD002XDOtherCAREFIRST OF MARYLAND
MD3175526OtherUNITED HEALTH CARE
MD415343000Medicaid
MD9443167OtherAETNA
MDD364OtherBLUE CROSS BLUE SHIELD-GHMSI
MD002XDOtherCAREFIRST OF MARYLAND
MD018750060OtherMARYLAND PHYSICIAN CARE