Provider Demographics
NPI:1457312332
Name:LANG, THOMAS JOHN (MD)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:JOHN
Last Name:LANG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:6350 STEVENS FOREST RD STE 101
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21046-3240
Mailing Address - Country:US
Mailing Address - Phone:410-992-7440
Mailing Address - Fax:
Practice Address - Street 1:6350 STEVENS FOREST RD STE 101
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21046-3240
Practice Address - Country:US
Practice Address - Phone:410-992-7440
Practice Address - Fax:443-276-0349
Is Sole Proprietor?:No
Enumeration Date:2006-03-30
Last Update Date:2023-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0052541207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDBL5654719OtherDEA
MDD0052541OtherSTATE LICENSE
MD296100800Medicaid
MDM43719OtherCDS
MD296100800Medicaid
MDBL5654719OtherDEA