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Individual
TAMIKO LONG
Active
Individual
TAMIKO LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
359766-1205
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
107008474101
IHC
UT
01
—
2000040
UNITED HEALTHCARE
UT
01
—
3068
HEALTHY U
UT
05
—
401765
—
MT
01
—
416957
DESERET MUTUAL
UT
01
—
49010
PEHP
UT
05
—
710302
—
AZ
01
—
870280408LO1
EDUCATORS MUTUAL
UT
01
—
PRA02016
MOLINA
UT
01
—
QM0000049529
ALTIUS
UT
Enumeration date
08/24/2006
Last updated
07/08/2007
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