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General NPI Number Information
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NPI Number | 1669840344
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Entity Type | Individual
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Provider Name | BRADLEY CARL LANG LDN
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Gender | Male
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Dates
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Enumeration Date | 09/11/2015
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Last Update Date | 09/11/2015
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Provider Practice Location Address
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Address Line | 101 MANNING DR CHILDREN'S HOSPITAL
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City | CHAPEL HILL
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State | NC
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Zip | 27514-4220
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Country | US
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Telephone | 984-974-7908
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Fax | 984-974-3217
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Provider Business Mailing Address
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Address Line | 101 MANNING DR CHILDREN'S HOSPITAL
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City | CHAPEL HILL
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State | NC
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Zip | 27514-4220
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Country | US
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Telephone | 984-974-7908
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Fax | 984-974-3217
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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 | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number | L004570N
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 133VN1004X
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Taxonomy Name | Pediatric Nutrition Registered Dietitian
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License Number | L004570
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License Number State | NC
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