Most Relevant Information
Provider Data
| NPI Number: | 1003659665 |
| Provider Name: | KATIE LONG MD |
| Entity Type: | Individual |
| Taxonomy Code: | 390200000X |
| Specialty: | Student in an Organized Health Care Education/Training Program |
| License Number: | 4351052360 |
Most Important Dates
| Enumeration Date: | 06/13/2024 |
| Last Updated: | 06/13/2024 |
Provider Practice Location
1500 E MEDICAL CENTER DR
ANN ARBOR
MI
481095000
Practice Location Phone/Fax
| Phone: | 7349364280 |
| Fax: |
Provider Mailing Location
1500 E MEDICAL CENTER DR
ANN ARBOR
MI
481095000
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |