Individual
DR. ROBERT DALE LONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3 HOSPITAL DR, LEWISBURG, PA 17837
(570) 523-1109
(570) 523-7736
Mailing address
3 HOSPITAL DR, LEWISBURG, PA 17837
(570) 523-1109
(570) 523-7736
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
MD016589E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
02500700
BLUE CROSS
—
01
—
LO70425
BLUE SHIELD
—
Enumeration date
04/12/2006
Last updated
08/21/2010
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