Provider Demographics
NPI:1730307463
Name:LANG, DENNIS J (DO)
Entity Type:Individual
Prefix:
First Name:DENNIS
Middle Name:J
Last Name:LANG
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:PO BOX 3239
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:SC
Mailing Address - Zip Code:29502-3239
Mailing Address - Country:US
Mailing Address - Phone:843-777-7162
Mailing Address - Fax:843-777-7102
Practice Address - Street 1:115 N SUMTER ST
Practice Address - Street 2:SUITE 410
Practice Address - City:SUMTER
Practice Address - State:SC
Practice Address - Zip Code:29150-4972
Practice Address - Country:US
Practice Address - Phone:803-883-5171
Practice Address - Fax:803-305-1814
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-20
Last Update Date:2021-02-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
SC1164207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC011640Medicaid
SCP01232420OtherRAILROAD MEDICARE
SC0655422OtherCIGNA
SC30150986OtherSELECT HEALTH
SC266003OtherMEDCOST
SCAA30048552OtherMEDICARE PTAN
SC929530OtherWELLCARE