Provider Demographics
NPI:1144580572
Name:LANGER, MARK
Entity Type:Individual
Prefix:MR
First Name:MARK
Middle Name:
Last Name:LANGER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:150 MOUNT PLEASANT DRIVE
Mailing Address - Street 2:
Mailing Address - City:CAMROSE
Mailing Address - State:ALBERTA
Mailing Address - Zip Code:T4V 3H3
Mailing Address - Country:CA
Mailing Address - Phone:503-686-3597
Mailing Address - Fax:
Practice Address - Street 1:150 MOUNT PLEASANT DRIVE
Practice Address - Street 2:
Practice Address - City:CAMROSE
Practice Address - State:ALBERTA
Practice Address - Zip Code:T4V 3H3
Practice Address - Country:CA
Practice Address - Phone:503-686-3597
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-05-18
Last Update Date:2012-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program