Healthcare Provider Details

I. General information

NPI: 1083608236
Provider Name (Legal Business Name): ANN MARIE LANGHAM DO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: ANN MARIE TANISH

II. Dates (important events)

Enumeration Date: 09/02/2005
Last Update Date: 01/10/2025
Certification Date: 01/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

457 REBERS BRIDGE RD
SINKING SPRING PA
19608-9616
US

IV. Provider business mailing address

457 REBERS BRIDGE RD
SINKING SPRING PA
19608-9616
US

V. Phone/Fax

Practice location:
  • Phone: 484-919-1078
  • Fax: 610-678-8389
Mailing address:
  • Phone: 484-919-1078
  • Fax: 610-678-8389

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberOS012806
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: