Basic Information
| Provider Information | |||||||||
| NPI: | 1992765440 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | LANGIULLI | ||||||||
| FirstName: | MICHAEL | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5959 S SHERWOOD FOREST BLVD | ||||||||
| Address2: | |||||||||
| City: | BATON ROUGE | ||||||||
| State: | LA | ||||||||
| PostalCode: | 708166038 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2255260011 | ||||||||
| FaxNumber: | 2257659196 | ||||||||
| Practice Location | |||||||||
| Address1: | 312 GRAMMONT ST | ||||||||
| Address2: | SUITE 303 | ||||||||
| City: | MONROE | ||||||||
| State: | LA | ||||||||
| PostalCode: | 712017457 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3189668850 | ||||||||
| FaxNumber: | 3189668851 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/27/2006 | ||||||||
| LastUpdateDate: | 05/05/2017 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RC0000X | MD.203554 | LA | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease | 207RI0011X | 203554 | LA | N | Allopathic & Osteopathic Physicians | Internal Medicine | Interventional Cardiology | 207R00000X | 203554 | LA | N | Allopathic & Osteopathic Physicians | Internal Medicine |
ID Information
| ID | Type | State | Issuer | Description | 02796601 | 05 | NY | MEDICAID | 223720 | 01 | NY | NY LICENSE | OTHER | C03054 | 01 | CT | MEDICARE GROUP NUMBER | OTHER | 1822604 | 05 | LA | MEDICAID |