Basic Information
Provider Information
NPI: 1144407958
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: LANG
FirstName: SEAN
MiddleName: MICHAEL
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 3333 BURNET AVE.
Address2: ML 2023
City: CINCINNATI
State: OH
PostalCode: 452293026
CountryCode: US
TelephoneNumber: 5136364432
FaxNumber: 5136363952
Practice Location
Address1: 3333 BURNET AVE.
Address2: ML 2023
City: CINCINNATI
State: OH
PostalCode: 45229
CountryCode: US
TelephoneNumber: 5136364432
FaxNumber: 5136363952
Other Information
ProviderEnumerationDate: 01/23/2008
LastUpdateDate: 06/08/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2080P0202XE-8725ARN Allopathic & Osteopathic PhysiciansPediatricsPediatric Cardiology
2080P0202X51153KYN Allopathic & Osteopathic PhysiciansPediatricsPediatric Cardiology
2080P0202X01079713AINN Allopathic & Osteopathic PhysiciansPediatricsPediatric Cardiology
2080P0202X35.121519OHY Allopathic & Osteopathic PhysiciansPediatricsPediatric Cardiology

No ID Information.


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