Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RH0003X | Hematology & Oncology | 2004012760 | MO |
NPI | 1043281413 |
---|---|
Provider Name | Dr. Aaron Lang |
First Address | Cape Girardeau, MO 63701-4505 |
Second Address | Cape Girardeau, MO 63701-4505 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/02/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F18236 | (02) | MO |