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General NPI Number Information
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NPI Number | 1851620546
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Entity Type | Organization
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Legal Business Name | DR. MONIQUE Y LANGSTON & ASSOCIATES P A
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Dates
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Enumeration Date | 12/09/2009
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Last Update Date | 08/04/2011
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Provider Practice Location Address
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Address Line | 1616 FOREST DR SUITE 1
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City | ANNAPOLIS
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State | MD
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Zip | 21403-1019
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Country | US
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Telephone | 410-263-4400
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Fax | 410-268-5548
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Provider Business Mailing Address
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Address Line | 1616 FOREST DR SUITE 1
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City | ANNAPOLIS
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State | MD
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Zip | 21403-1019
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Country | US
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Telephone | 410-263-4400
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Fax | 410-268-5548
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. MONIQUE Y LANGSTON
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Credential | DO
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Telephone | 410-263-4400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | H0047494
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License Number State | MD
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