MEDICARE: SHAWN B LANGFORD

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	172V00000X	Community Health Worker		PA

General Provider Information

NPI Number	:	1548852908
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHAWN B LANGFORD

Provider Business Mailing Address
First Line	:	1302 STERRETT ST
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15208-1229
Country	:	US
Telephone Number	:	412-499-5014
Fax Number	:

Provider Business Practice Location Address
First Line	:	1302 STERRETT ST
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15208-1229
Country	:	US
Telephone Number	:	412-499-5014
Fax Number	:

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

Provider Enumeration Date	:	02/08/2021
Last Update Date	:	02/08/2021

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Directions to “ SHAWN B LANGFORD ” Practice Location

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