Healthcare Provider Details

I. General information

NPI: 1003876194
Provider Name (Legal Business Name): MARK STERLING LANGFITT MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/24/2006
Last Update Date: 10/04/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 CADMUS LANE SUITE 210
EASTON MD
21601-3857
US

IV. Provider business mailing address

500 CADMUS LANE SUITE 210
EASTON MD
21601-3857
US

V. Phone/Fax

Practice location:
  • Phone: 410-822-8550
  • Fax: 410-822-3741
Mailing address:
  • Phone: 410-822-8550
  • Fax: 410-822-3741

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberD0050094
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: