Provider Demographics
NPI:1265565592
Name:LANGSTON, MONIQUE YVETTE (DO)
Entity type:Individual
Prefix:DR
First Name:MONIQUE
Middle Name:YVETTE
Last Name:LANGSTON
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:1616 FOREST DR
Mailing Address - Street 2:SUITE 1
Mailing Address - City:ANNAPOLIS
Mailing Address - State:MD
Mailing Address - Zip Code:21403-1019
Mailing Address - Country:US
Mailing Address - Phone:410-263-4400
Mailing Address - Fax:410-268-5548
Practice Address - Street 1:1616 FOREST DR
Practice Address - Street 2:SUITE 1
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21403-1019
Practice Address - Country:US
Practice Address - Phone:410-263-4400
Practice Address - Fax:410-268-5548
Is Sole Proprietor?:No
Enumeration Date:2007-03-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDH0047494207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine