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General NPI Number Information
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NPI Number | 1245212117
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Entity Type | Individual
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Provider Name | KARL MICHAEL LANG CORREA MD
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Gender | Male
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Dates
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Enumeration Date | 11/16/2005
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Last Update Date | 08/29/2017
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Provider Practice Location Address
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Address Line | CARR # 2 KM 40.1 BARRIO ALGARROBO
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City | VEGA BAJA
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State | PR
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Zip | 00693
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Country | US
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Telephone | 787-807-2297
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Fax | 787-884-0688
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Provider Business Mailing Address
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Address Line | PO BOX 1084
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City | MANATI
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State | PR
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Zip | 00674-1084
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Country | US
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Telephone | 787-884-5100
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Fax | 787-807-2298
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 8482
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License Number State | PR
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