Individual
DANIEL EDWARD LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
9825 KENWOOD RD, SUITE 105, BLUE ASH, OH 45242-6251
(513) 872-4500
(513) 872-4518
Mailing address
9825 KENWOOD RD, SUITE 105, BLUE ASH, OH 45242-6251
(513) 872-4500
(513) 872-4518
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
35072384
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200320180
—
IN
05
—
2198885
—
OH
05
—
64035090
—
KY
Enumeration date
05/26/2006
Last updated
07/19/2011
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