Long, Michael

Long, Michael is an individual health care provider with primary practice located at 7150 Clearvista Dr , Indianapolis IN 46256-1695. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered, which is considered as his primary health care specialty. Long, Michael can be contacted via phone (317) 621-5890.

Contact Information

Primary practice address
7150 Clearvista Dr Indianapolis IN 46256-1695
Phone: (317) 621-5890
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X 523585 New York
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X 28238168A Indiana

Profile Details

NPI number 1740256882
LBN Legal business name Long, Michael
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 28th, 2006
Last updated Nov 27th, 2023 - about last year

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 1740256882 NPPES
Indiana MEDICAID 300008953

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