Individual
LISA LONGUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2435 W BELVEDERE AVE, BALTIMORE, MD 21215-5224
(410) 601-6840
Mailing address
2435 W BELVEDERE AVE, BALTIMORE, MD 21215-5224
(410) 601-6840
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
R210999
MD
Other
Enumeration date
12/11/2024
Last updated
12/11/2024
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