Individual
DR. STEPHEN E LONG
Active
Individual
DR. STEPHEN E LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207U00000X
Nuclear Medicine Physician
Primary
R6H16
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
138827001
—
AR
05
—
1629117510
—
MO
01
—
173098
MO BLUE SHIELD
MO
01
—
431560263
TRICARE
MO
01
—
81453
ARK BLUE SHIELD
AR
Enumeration date
02/06/2007
Last updated
05/24/2013
Update your record
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