MEDICARE: DR. MICHAEL JOHN LANG 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	2080N0001X	Neonatal-Perinatal Medicine Physician	04-27075	KS

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

General Provider Information

NPI Number	:	1780625210
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHAEL JOHN LANG M.D.

Provider Business Mailing Address
First Line	:	901 E WILLETTA ST
Second Line	:	STE 2503
City	:	PHOENIX
State	:	AZ
Zip	:	85006-2727
Country	:	US
Telephone Number	:	602-839-2307
Fax Number	:	602-839-2307

Provider Business Practice Location Address
First Line	:	901 E WILLETTA ST
Second Line	:	STE 2503
City	:	PHOENIX
State	:	AZ
Zip	:	85006-2727
Country	:	US
Telephone Number	:	602-839-2307
Fax Number	:	602-839-2307

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

Provider Enumeration Date	:	06/08/2006
Last Update Date	:	08/30/2010

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Directions to “ DR. MICHAEL JOHN LANG M.D.” Practice Location

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