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Individual
STEWART MCLENDON LONG III
Active
Individual
STEWART MCLENDON LONG III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
054274
GA
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
2020-00263
NC
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
MED-PHYS-LIC-11421
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1588720007
—
NC
01
—
NNB571A
MEDICARE
NC
Enumeration date
12/29/2006
Last updated
08/01/2024
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