Individual
ANDREW JAMES LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
419 S CORAL ST, KALKASKA, MI 49646-2503
(231) 258-7777
(231) 935-8099
Mailing address
419 S CORAL ST, KALKASKA, MI 49646-2503
(231) 258-7777
(231) 935-8099
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
5101016386
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1558554808
—
MI
Enumeration date
08/21/2007
Last updated
05/04/2021
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