Long, Mary Ann

Long, Mary Ann is an individual health care provider with primary practice located at 1 Medical Center Drive , Morgantown WV 26506. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Group / Groups of Doctors / Multi-Specialty. Group / Groups of Doctors / Multi-Specialty is her primary health care specialty. Long, Mary Ann can be contacted via phone (304) 598-6900.

Contact Information

Primary practice address
1 Medical Center Drive Morgantown WV 26506
Fax: (304) 598-6914
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 21188 West Virginia
Group / Groups of Doctors / Multi-Specialty 193200000X 21188 West Virginia

Profile Details

NPI number 1679685150
LBN Legal business name Long, Mary Ann
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 31st, 2006
Last updated Sep 22nd, 2015 - about 9 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 1679685150 NPPES
West Virginia MEDICAID 3810000059

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