Individual
DR. MATTHEW T LANGENBERG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
520 MARY ST, STE 520, EVANSVILLE, IN 47710
(812) 424-8231
(812) 435-8794
Mailing address
520 MARY ST STE 520, EVANSVILLE, IN 47710-1682
(812) 424-8231
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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