MEDICARE: DAPHNE C LANG 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	207QG0300X	Geriatric Medicine (Family Medicine) Physician	MD27061	ME
2	207Q00000X	Family Medicine Physician	MD22178	ME

General Provider Information

NPI Number	:	1730592205
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAPHNE C LANG MD

Provider Business Mailing Address
First Line	:	4 SHERIDAN RD
Second Line	:
City	:	FAIRFIELD
State	:	ME
Zip	:	04937-3314
Country	:	US
Telephone Number	:	207-453-3000
Fax Number	:

Provider Business Practice Location Address
First Line	:	11 CAPE JELLISON RD
Second Line	:
City	:	STOCKTON SPRINGS
State	:	ME
Zip	:	04981-4349
Country	:	US
Telephone Number	:	207-567-4000
Fax Number	:

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

Provider Enumeration Date	:	06/03/2014
Last Update Date	:	03/25/2025

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