Provider Demographics
NPI:1831131788
Name:LANG, DAVID (DO)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:LANG
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:26901 BEAUMONT BLVD STE 3D
Mailing Address - Street 2:
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48033-3849
Mailing Address - Country:US
Mailing Address - Phone:947-522-1862
Mailing Address - Fax:947-522-0307
Practice Address - Street 1:28711 8 MILE RD STE D
Practice Address - Street 2:
Practice Address - City:LIVONIA
Practice Address - State:MI
Practice Address - Zip Code:48152-2041
Practice Address - Country:US
Practice Address - Phone:248-482-8830
Practice Address - Fax:248-482-8840
Is Sole Proprietor?:No
Enumeration Date:2006-06-12
Last Update Date:2020-11-14
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MI5101013764207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI58207705Medicaid
MIC7872OtherMCARE
MIP111081OtherBLUE CROSS
MI4308685Medicaid
MI4036559OtherAETNA
MI4036559OtherAETNA