Provider Demographics
NPI:1073533626
Name:LANG, PAMELA JUNE (MD)
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:JUNE
Last Name:LANG
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:7974 UW HEALTH CT
Mailing Address - Street 2:
Mailing Address - City:MIDDLETON
Mailing Address - State:WI
Mailing Address - Zip Code:53562-5531
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:600 HIGHLAND AVE
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53792-6134
Practice Address - Country:US
Practice Address - Phone:608-263-6420
Practice Address - Fax:608-890-7675
Is Sole Proprietor?:No
Enumeration Date:2006-07-19
Last Update Date:2021-01-27
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
WI66334207X00000X
WI50-0392255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI50-039OtherATHLETIC TRAINER