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NPI Code Detail

MEDICARE: WILLIAM LONG MD

MEDICARE: WILLIAM LONG MD
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
12080P0202XPediatric Cardiology Physician82754MN

General Provider Information

NPI Number : 1760010813
Entity Type Code : Individual
Provider Name (Legal Business Name) : WILLIAM LONG MD
Provider Business Mailing Address
First Line : 2450 RIVERSIDE AVE
Second Line :
City : MINNEAPOLIS
State : MN
Zip : 55454-1450
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2450 RIVERSIDE AVE
Second Line :
City : MINNEAPOLIS
State : MN
Zip : 55454-1450
Country : US
Telephone Number : 612-365-1000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/01/2020
Last Update Date : 06/24/2026

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Directions to “ WILLIAM LONG MD” Practice Location

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