Provider Demographics
NPI:1851807663
Name:LANGLIE, MALI D (PA-C)
Entity Type:Individual
Prefix:
First Name:MALI
Middle Name:D
Last Name:LANGLIE
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:MALI
Other - Middle Name:D
Other - Last Name:HUNT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PA-C
Mailing Address - Street 1:LANDSTUHL REGIONAL MEDICAL CENTER
Mailing Address - Street 2:ATTN: MCEUL-DCCS (CREDENTIALS), CMR 402
Mailing Address - City:APO
Mailing Address - State:AE
Mailing Address - Zip Code:09180
Mailing Address - Country:US
Mailing Address - Phone:011-496-3718
Mailing Address - Fax:011-496-3718
Practice Address - Street 1:LANDSTUHL REGIONAL MEDICAL CENTER
Practice Address - Street 2:OCCUPATIONAL HEALTH
Practice Address - City:APO
Practice Address - State:AE
Practice Address - Zip Code:09180
Practice Address - Country:US
Practice Address - Phone:011-496-3718
Practice Address - Fax:011-496-3718
Is Sole Proprietor?:Yes
Enumeration Date:2017-12-18
Last Update Date:2017-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA54928363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedicalGroup - Single Specialty