Provider Demographics
NPI:1750375424
Name:LANG, ERIC A (MD)
Entity type:Individual
Prefix:
First Name:ERIC
Middle Name:A
Last Name:LANG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 20452
Mailing Address - Street 2:COPA-CRED
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43220-0452
Mailing Address - Country:US
Mailing Address - Phone:614-442-2406
Mailing Address - Fax:614-442-2410
Practice Address - Street 1:793 W STATE ST
Practice Address - Street 2:MCHS WEST-PATHOLOGY DEPT-COPA
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43222-1551
Practice Address - Country:US
Practice Address - Phone:614-234-1300
Practice Address - Fax:614-234-2931
Is Sole Proprietor?:No
Enumeration Date:2005-09-08
Last Update Date:2013-06-27
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
OH35070130207ZP0102X, 207ZC0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
No207ZC0500XAllopathic & Osteopathic PhysiciansPathologyCytopathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0790046OtherMCR PTAN-DPA
OH0790042OtherMCR PTAN-COPA
OH2237805Medicaid