MEDICARE: ADAM DAVID LANGENBRUNNER M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	390200000X	Student in an Organized Health Care Education/Training Program	141268	NC
2	207P00000X	Emergency Medicine Physician	2010-00098	NC

General Provider Information

NPI Number	:	1063693026
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ADAM DAVID LANGENBRUNNER M.D.

Provider Business Mailing Address
First Line	:	501 S SHARON AMITY RD STE 300
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28211-0035
Country	:	US
Telephone Number	:	704-377-2424
Fax Number	:	704-377-2687

Provider Business Practice Location Address
First Line	:	1028 LEE ANN DR NE
Second Line	:	SUITE 200
City	:	CONCORD
State	:	NC
Zip	:	28025-2903
Country	:	US
Telephone Number	:	704-782-1892
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/19/2007
Last Update Date	:	12/10/2019

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