Individual
DOMINIQUE NOE LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
600 N WOLFE ST, PARK 211, BALTIMORE, MD 21287-0005
(410) 955-6463
Mailing address
PO BOX 64316, BALTIMORE, MD 21264-4316
Taxonomy
Speciality
Code
Description
License number
State
2080P0205X
Pediatric Endocrinology Physician
Primary
D59951
MD
Other
Enumeration date
01/05/2007
Last updated
07/08/2007
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