MEDICARE: DR. WILLIAM LEONARD LANG MD, MHA

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	207Q00000X	Family Medicine Physician	0101044912	VA

General Provider Information

NPI Number	:	1508863622
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. WILLIAM LEONARD LANG MD, MHA

Provider Business Mailing Address
First Line	:	1600 PRINCE ST APT 255
Second Line	:
City	:	ALEXANDRIA
State	:	VA
Zip	:	22314-2836
Country	:	US
Telephone Number	:	571-334-4582
Fax Number	:

Provider Business Practice Location Address
First Line	:	1600 PRINCE ST STE 113
Second Line	:
City	:	ALEXANDRIA
State	:	VA
Zip	:	22314-2836
Country	:	US
Telephone Number	:	571-334-4582
Fax Number	:

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

Provider Enumeration Date	:	07/05/2005
Last Update Date	:	07/20/2023

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