Individual
CHARLES W LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
8800 N TRYON ST, CHARLOTTE, NC 28262-3300
(704) 548-5663
(704) 548-6997
Mailing address
509 BILTMORE AVE, ASHEVILLE, NC 28801-4601
(828) 213-2325
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
0032772
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
032772
—
SC
05
—
8952588
—
NC
Enumeration date
10/10/2005
Last updated
01/09/2019
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