Individual
RANDI J. LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3601 W 13 MILE ROAD, ROYAL OAK, MI 48073
(248) 809-1227
(248) 809-1228
Mailing address
33717 WOODWARD AVE STE 416, BIRMINGHAM, MI 48009-0913
(248) 809-1227
(248) 809-1228
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
4301056088
MI
208100000X
Physical Medicine & Rehabilitation Physician
Primary
4301056088
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3480240
—
MI
Enumeration date
01/03/2007
Last updated
01/15/2025
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