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Individual

SUSAN E. LONG

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
1 AMALIA DR, BUCKHANNON, WV 26201-2239
(304) 473-2000
(304) 473-2180
Mailing address
1 AMALIA DR, BUCKHANNON, WV 26201-2239
(304) 473-2000
(304) 473-2180

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
18992
WV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0126735000
WV
Enumeration date
07/21/2006
Last updated
04/06/2022
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