Scott, Tara Long

Scott, Tara Long is an sole proprietor health care provider with primary practice located at 29425 Northwestern Hwy Ste 125, Southfield MI 48034-1083. She recently has only one registered license in Podiatric Medicine & Surgery Service Providers / Podiatrist, which is considered as her primary health care specialty. Scott, Tara Long can be contacted via phone (248) 557-6500.

Contact Information

Primary practice address
29425 Northwestern Hwy Ste 125 Southfield MI 48034-1083
Phone: (248) 557-6500
Fax: (248) 557-2781
Website:
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Health care specialties

SpecialtyCodeLicense #State
Podiatric Medicine & Surgery Service Providers / Podiatrist 213E00000X TS001844 Michigan

Profile Details

NPI number 1972535862
LBN Legal business name Scott, Tara Long
Credentials Doctor of Podiatric Medicine (DPM)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 7th, 2006
Last updated Dec 1st, 2016 - about 8 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 1972535862 NPPES
Michigan MEDICAID 4842666
Michigan Other 16951
Michigan Other 5889627
Michigan Other 61783
Michigan Other P00292714
Michigan Other TS001844
Michigan Other U76095

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