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NPI Code Detail

MEDICARE: DAVID LONG

MEDICARE: DAVID LONG
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163WM0705XMedical-Surgical Registered Nurse448265OH

General Provider Information

NPI Number : 1700739687
Entity Type Code : Individual
Provider Name (Legal Business Name) : DAVID LONG
Provider Business Mailing Address
First Line : 511 SUNSET AVE
Second Line :
City : SHEFFIELD LAKE
State : OH
Zip : 44054-1362
Country : US
Telephone Number : 216-905-1657
Fax Number :
Provider Business Practice Location Address
First Line : 11000 EUCLID AVE
Second Line :
City : CLEVELAND
State : OH
Zip : 44106-1714
Country : US
Telephone Number : 216-844-1000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/19/2026
Last Update Date : 02/19/2026

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Directions to “ DAVID LONG ” Practice Location

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