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Individual
MR. PAUL LONG
Active
Individual
MR. PAUL LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
266030
MA
207R00000X
Internal Medicine Physician
A169774
CA
Other
Enumeration date
05/03/2013
Last updated
08/30/2021
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