Provider Demographics
NPI:1831270206
Name:LANG, STEPHEN P (MD)
Entity type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:P
Last Name:LANG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:310 MEDICAL DR STE 101
Mailing Address - Street 2:
Mailing Address - City:CARMEL
Mailing Address - State:IN
Mailing Address - Zip Code:46032-3078
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:310 MEDICAL DR
Practice Address - Street 2:SUITE 101
Practice Address - City:CARMEL
Practice Address - State:IN
Practice Address - Zip Code:46032-3077
Practice Address - Country:US
Practice Address - Phone:317-415-6350
Practice Address - Fax:317-415-6351
Is Sole Proprietor?:No
Enumeration Date:2006-10-18
Last Update Date:2022-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01039476A207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
000000084075OtherANTHEM
IN100332710AMedicaid
IN100332710AMedicaid
000000084075OtherANTHEM