MEDICARE: DR. EVAN Z LANG MD

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	207RH0003X	Hematology & Oncology Physician	36755	KY
2	207RH0003X	Hematology & Oncology Physician	01062629A	IN
3	207RH0003X	Hematology & Oncology Physician	35072598	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1639163033
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. EVAN Z LANG MD

Provider Business Mailing Address
First Line	:	5053 WOOSTER RD
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45226-2326
Country	:	US
Telephone Number	:	513-751-2145
Fax Number	:	513-751-2138

Provider Business Practice Location Address
First Line	:	860 NW WASHINGTON BLVD
Second Line	:
City	:	HAMILTON
State	:	OH
Zip	:	45013-6382
Country	:	US
Telephone Number	:	513-751-2145
Fax Number	:

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

Provider Enumeration Date	:	08/31/2005
Last Update Date	:	04/19/2021

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Directions to “ DR. EVAN Z LANG MD” Practice Location

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