Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | 9900911 | NC |
NPI | 1003815937 |
---|---|
Provider Name | John M. Lang |
First Address | Fletcher, NC 28732-1869 |
Second Address | Asheville, NC 28803-5006 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/07/2005 |
Last Update Date | 17/11/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
129A8 | BCBS (01) | NC |
89129A8 | (05) | NC |
H39787 | (02) | |
P00682107 | MEDICARE RAILROAD (01) | NC |