MEDICARE: ANDREW LANGSAM MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208D00000X	General Practice Physician	MD2010-0670	NM

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	486804YN7R	OTHER	NM	MEDICARE PTAN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1447238159
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANDREW LANGSAM MD

Provider Business Mailing Address
First Line	:	3450 ZAFARANO DR
Second Line	:	SUITE C
City	:	SANTA FE
State	:	NM
Zip	:	87507-2669
Country	:	US
Telephone Number	:	505-466-5885
Fax Number	:	505-466-5886

Provider Business Practice Location Address
First Line	:	3450 ZAFARANO DR
Second Line	:	SUITE C
City	:	SANTA FE
State	:	NM
Zip	:	87507-2669
Country	:	US
Telephone Number	:	505-466-5885
Fax Number	:	505-466-5886

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/03/2006
Last Update Date	:	06/03/2016

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