Doctor Name: | WALTER JR. LANG |
NPI Number: | 1063690881 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MD |
License Number: | ME11741 |
Business Practice Address: | 8175 Nw 12th St Suite 306 Doral, FL - 331261828 |
Business Phone Number: | 7868450173 |
Business Fax Number: | 7868450176 |
Mailing Address: | 8175 Nw 12th St, Suite 306 DORAL |
State: | FL |
Postal Code: | 331261828 |
Phone Number: | 7868450173 |
Fax Number: | 7868450176 |
NPI Enumeration Date: | 02/04/2008 |
NPI Last Update Date: | 02/04/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | ME11741 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |