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Individual
DR. MICHAEL SCOTT LONG
Active
Individual
DR. MICHAEL SCOTT LONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
OS015429
PA
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
QQ498
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
337951301
—
TX
05
—
337951302
—
TX
01
—
8EK438
BLUE CROSS BLUE SHIELD
TX
01
—
8EM612
BLUE CROSS BLUE SHIELD
TX
01
—
P01360899
RAILROAD MEDICARE
—
Enumeration date
09/11/2012
Last updated
12/22/2015
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