Provider Demographics
NPI:1740272137
Name:LANGLOIS, SCOTT DAVID (CRNA)
Entity type:Individual
Prefix:MR
First Name:SCOTT
Middle Name:DAVID
Last Name:LANGLOIS
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3703 ALTONDALE RD
Mailing Address - Street 2:
Mailing Address - City:REISTERSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21136-4003
Mailing Address - Country:US
Mailing Address - Phone:410-374-0601
Mailing Address - Fax:
Practice Address - Street 1:3703 ALTONDALE RD
Practice Address - Street 2:
Practice Address - City:REISTERSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21136-4003
Practice Address - Country:US
Practice Address - Phone:410-374-0601
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR107949367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered