Provider Demographics
NPI:1225321797
Name:LANGSAM, SETH BENJAMIN (MD)
Entity Type:Individual
Prefix:
First Name:SETH
Middle Name:BENJAMIN
Last Name:LANGSAM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1120 W MICHIGAN ST
Mailing Address - Street 2:CL 260
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46202-5209
Mailing Address - Country:US
Mailing Address - Phone:317-278-0042
Mailing Address - Fax:317-278-0027
Practice Address - Street 1:1120 W MICHIGAN ST
Practice Address - Street 2:CL 260
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46202-5209
Practice Address - Country:US
Practice Address - Phone:317-278-0042
Practice Address - Fax:317-278-0027
Is Sole Proprietor?:No
Enumeration Date:2011-05-17
Last Update Date:2016-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301098477390200000X, 207P00000X
IN01076665A207RC0200X, 207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine