Organization
MEDICAL PLAZA FAMILY & GERIATRIC PHYSICIANS, PA
Active
Organization
MEDICAL PLAZA FAMILY & GERIATRIC PHYSICIANS, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WILLIAM J LONG MD (PHYSICIAN/OWNER)
(704) 944-0975
Entity
Organization
Contact information
Practice address
8401 MEDICAL PLAZA DR, SUITE 365, CHARLOTTE, NC 28262-8797
(704) 944-0975
(704) 943-0699
Mailing address
8401 MEDICAL PLAZA DR, SUITE 365, CHARLOTTE, NC 28262-8797
(704) 944-0975
(704) 943-0699
Taxonomy
Speciality
Code
Description
License number
State
207QG0300X
Geriatric Medicine (Family Medicine) Physician
Primary
189833
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5922886
—
NC
Enumeration date
02/06/2013
Last updated
04/27/2023
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