Long, Lisa M

Long, Lisa M is an individual health care provider with primary practice located at 1414 W Fair Ave Ste 36, Marquette MI 49855-2675. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Long, Lisa M can be contacted via phone (906) 225-3864.

Contact Information

Primary practice address
1414 W Fair Ave Ste 36 Marquette MI 49855-2675
Phone: (906) 225-3864
Fax: (906) 225-3851
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 4301074655 Michigan

Profile Details

NPI number 1326039462
LBN Legal business name Long, Lisa M
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 28th, 2005
Last updated Apr 21st, 2009 - about 15 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 1326039462 NPPES
Michigan Other 080187364 RAILROAD MEDICARE
Michigan MEDICAID 4416083 RAILROAD MEDICARE

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