Provider Demographics
NPI:1659374932
Name:LANG, JAY MICHAEL (DO)
Entity Type:Individual
Prefix:
First Name:JAY
Middle Name:MICHAEL
Last Name:LANG
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:520 UPPER CHESAPEAKE DR
Mailing Address - Street 2:SUITE 201
Mailing Address - City:BEL AIR
Mailing Address - State:MD
Mailing Address - Zip Code:21014-4339
Mailing Address - Country:US
Mailing Address - Phone:443-643-3800
Mailing Address - Fax:443-643-3856
Practice Address - Street 1:520 UPPER CHESAPEAKE DR
Practice Address - Street 2:SUITE 201
Practice Address - City:BEL AIR
Practice Address - State:MD
Practice Address - Zip Code:21014-4339
Practice Address - Country:US
Practice Address - Phone:443-643-3800
Practice Address - Fax:443-643-3856
Is Sole Proprietor?:No
Enumeration Date:2005-05-31
Last Update Date:2010-06-24
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Provider Licenses
StateLicense IDTaxonomies
MDH0044463207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD242821100Medicaid
MD242821100Medicaid
MD141986ZCDKMedicare PIN