Individual
MICHAEL LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2450 RIVERSIDE AVE, MINNEAPOLIS, MN 55454-1450
(612) 672-6000
Mailing address
2450 RIVERSIDE AVE, MINNEAPOLIS, MN 55454-1400
(612) 672-6000
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
34481
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
825714100
—
MN
Enumeration date
11/29/2005
Last updated
09/28/2021
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