Healthcare Provider Details

I. General information

NPI: 1194011676
Provider Name (Legal Business Name): LINDSEY ANN LONG M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LINDSEY A LOEW M.D.

II. Dates (important events)

Enumeration Date: 06/23/2011
Last Update Date: 08/01/2025
Certification Date: 08/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4343 CONCOURSE DR STE 150
ANN ARBOR MI
48108-8672
US

IV. Provider business mailing address

4343 CONCOURSE DR STE 150
ANN ARBOR MI
48108-8672
US

V. Phone/Fax

Practice location:
  • Phone: 734-834-0926
  • Fax: 734-345-1013
Mailing address:
  • Phone: 734-834-0926
  • Fax: 734-345-1013

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number4301098357
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: