Individual
STEWART MCLENDON LONG III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
500 W BROADWAY ST, MISSOULA, MT 59802-4008
(406) 329-5612
(406) 329-5606
Mailing address
PO BOX 12, LIBERTY LAKE, WA 99019-0012
(509) 824-1284
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
054274
GA
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
2020-00263
NC
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
MED-PHYS-LIC-11421
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1588720007
—
NC
01
—
NNB571A
MEDICARE
NC
Enumeration date
12/29/2006
Last updated
08/01/2024
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