Individual
DEBORAH LONGLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1300 MICHIGAN ST NE, S-103, GRAND RAPIDS, MI 49503-2026
(616) 459-8338
Mailing address
4085 BURTON ST SE, STE 200, GRAND RAPIDS, MI 49546-2444
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
4301042796
MI
Other
Enumeration date
06/06/2006
Last updated
07/08/2007
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