Healthcare Provider Details

I. General information

NPI: 1992780183
Provider Name (Legal Business Name): TODD T LANGAGER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/09/2005
Last Update Date: 08/29/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

202 10TH ST SE SUITE 225
CEDAR RAPIDS IA
52403-2404
US

IV. Provider business mailing address

202 10TH ST SE SUITE 225
CEDAR RAPIDS IA
52403-2404
US

V. Phone/Fax

Practice location:
  • Phone: 319-364-7101
  • Fax: 319-363-1993
Mailing address:
  • Phone: 319-364-7101
  • Fax: 319-363-1993

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0001X
TaxonomyClinical Cardiac Electrophysiology Physician
License Number21191
License Number StateIA
# 2
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number21191
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: