Provider Demographics
NPI:1730592205
Name:LANG, DAPHNE C (MD)
Entity type:Individual
Prefix:
First Name:DAPHNE
Middle Name:C
Last Name:LANG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 SHERIDAN RD
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:ME
Mailing Address - Zip Code:04937-3314
Mailing Address - Country:US
Mailing Address - Phone:207-453-3000
Mailing Address - Fax:
Practice Address - Street 1:11 CAPE JELLISON RD
Practice Address - Street 2:
Practice Address - City:STOCKTON SPRINGS
Practice Address - State:ME
Practice Address - Zip Code:04981-4349
Practice Address - Country:US
Practice Address - Phone:207-567-4000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-03
Last Update Date:2025-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEMD27061207QG0300X
MEMD22178207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric Medicine