Individual
AMI TAILOR LANGDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
074381
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003138044B
—
GA
01
—
P01593953
RAILROAD MEDICARE
GA
Enumeration date
04/04/2012
Last updated
02/09/2023
Update your record
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