Individual
MARK ALLEN LANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
667 EASTLAND AVE SE, WARREN, OH 44484-4503
(330) 841-4000
(330) 841-4455
Mailing address
4135 BOARDMAN CANFIELD RD, SUITE 101, CANFIELD, OH 44406-9803
(330) 286-5330
(330) 286-5396
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RN.229173.COA-1
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2438339
—
OH
01
—
8232481
MEDICARE PTAN
OH
01
—
P00064161
MEDICARE RAILROAD
OH
Enumeration date
06/30/2006
Last updated
02/19/2015
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