Lange, Gavin Charles

Lange, Gavin Charles is an individual health care provider with primary practice located at 6701 Harford Rd , Parkville MD 21234-7721. He recently has only one registered license in Eye and Vision Services Providers / Technician/Technologist, which is considered as his primary health care specialty. Lange, Gavin Charles can be contacted via phone (410) 254-2055.

Contact Information

Primary practice address
6701 Harford Rd Parkville MD 21234-7721
Phone: (410) 254-2055
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Technician/Technologist 156F00000X T27627 Maryland

Profile Details

NPI number 1710693163
LBN Legal business name Lange, Gavin Charles
Credentials PHARMACY TECHNICIAN
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 30th, 2023
Last updated Feb 1st, 2023 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1710693163 NPPES
Maryland Other MD10272062356 LICENSE

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