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Individual
DR. MATTHEW T LANGENBERG
Active
Individual
DR. MATTHEW T LANGENBERG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
01075972A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000978343
ANTHEM BLUE CROSS BLUE SHIELD
IN
05
—
201332370
—
IN
05
—
7100229330
—
KY
05
—
XXXXXXXXX001
—
IL
Enumeration date
10/17/2005
Last updated
08/02/2018
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