Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0120X | Pediatric Surgery | 4301069906 | MI |
NPI | 1093715450 |
---|---|
Provider Name | Scott E. Langenburg |
First Address | Toledo, OH 43606-3845 |
Second Address | Toledo, OH 43606-3845 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/07/2005 |
Last Update Date | 21/03/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000000521515 | ANTHEM (01) | OH |
04561 | PARAMOUNT (01) | OH |
146595 | GLHP (01) | |
2486804 | (05) | OH |
2486804 | BCMH (01) | OH |
4072053 | (05) | MI |
4115606 | (05) | MI |
4672412 | (05) | MI |
5202232 | (05) | MI |
7633064 | AETNA (01) | OH |
7660 | HEALTH PLAN OF MI (01) | |
G90455 | (02) | |
SL069906 | COMMERCIAL-COMMERCIAL NUMBER (01) |