MICHAEL M LONG MD PC (NPI# 1356548507) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1356548507 |
| Entity Type | Organization |
| Organization Name | MICHAEL M LONG MD PC |
| Practice Address |
6424 E Broadway Rd 104 Mesa AZ 85206-1750 |
| Mailing Address |
1432 S Dobson Rd 106 Mesa AZ 85202-4768 |
| Practice Telephone | 4809855331 |
| Practice Fax Number | 4809246919 |
| Mailing Telephone | 4809693637 |
| Mailing Fax Number | 4809696568 |
| Enumeration Date | 2007-06-29 |
| Last Update Date | 2008-04-09 |
| Authorized Official Name | JULIE CASILLAS (ADMINISTRATOR) |
| Authorized Official Telephone | 4809694634 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RH0003X |
Internal Medicine Specialization: Hematology & Oncology |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AZ | 28583402 | 05 |
| Street Address |
6424 E BROADWAY RD 104 |
| City | MESA |
| State | AZ |
| Zip Code | 85206-1750 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003821430 | Sanjeev Gopal | Internal Medicine | 6424 E Broadway Rd, 104-105, Mesa, AZ 85206-1750 | 2006-07-31 |
| 1730625526 | Choice Spine and Pain, LLC | Clinic/Center | 6424 E Broadway Rd, Suite 102, Mesa, AZ 85206-1750 | 2017-01-17 |
| 1518338326 | Elevate Anesthesia Services, Inc. | Anesthesiology | 6424 E Broadway Rd, Suite 102, Mesa, AZ 85206-1750 | 2015-10-20 |
| 1710322946 | Sun Electronic Brachytherapy Inc | Radiology | 6424 E Broadway Rd, Suite 104 & 105, Mesa, AZ 85206-1750 | 2013-05-01 |
| 1093947392 | Kay Marie Scala | Nurse Practitioner | 6424 E Broadway Rd, Suite 104, Mesa, AZ 85206-1750 | 2009-08-20 |
| 1801026893 | Bradley Carl Davis | Radiology | 6424 E Broadway Rd, Ste 101, Mesa, AZ 85206-1750 | 2009-07-23 |
| 1740450311 | Banner Baywood Surgery Center, Lp | Clinic/Center | 6424 E Broadway Rd, Suite 102, Mesa, AZ 85206-1750 | 2008-03-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720693062 | Inner Balance Counseling LLC | Counselor | 4111 E Auto Valley Drive, Suite 101, Mesa, AZ 85206 | 2020-09-14 |
| 1356978969 | Choices 4 Change Counseling and Coaching LLC | Social Worker | 3707 E Southern Ave., Suite 2027, Mesa, AZ 85206 | 2020-03-24 |
| 1023651288 | Jason Mcclure | Hearing Instrument Specialist | 5540 E Broadway Rd., Mesa, AZ 85206 | 2019-10-21 |
| 1255995361 | Vhs of Phoenix Inc | General Acute Care Hospital | 5750 E. Baseline Rd., Mesa, AZ 85206 | 2019-04-24 |
| 1932682184 | Adam Fishel Frose | Psychologist | 4555 E Inverness Ave Ste 112, Mesa, AZ 85206 | 2018-09-13 |
| 1376024737 | Robyn Kathleen Hall | Psychologist | 4115 East Valley Auto Drive, Suite 208, Mesa, AZ 85206 | 2018-08-23 |
| 1790264984 | Perspective Health, LLC | Clinic/Center | 1959 S. Power Rd, Suite 103, #206, Mesa, AZ 85206 | 2018-08-09 |
| 1033605159 | Rebecca Ann Maro | Nurse Practitioner | 6750 E Baywood Ave Ste 502, Mesa, AZ 85206 | 2018-07-02 |
| 1982195624 | Spark Performance and Physiotherapy | Clinic/Center | 6056 East Basline Road, Suite 147, Mesa, AZ 85206 | 2018-05-29 |
| 1336645993 | Ashley Wright | Audiologist-Hearing Aid Fitter | 1423 S Higley Rd Ste 119, Mesa, AZ 85206 | 2018-04-03 |
| Find all providers in zip 85206 | ||||
| Taxonomy Code | 207RH0003X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Hematology & Oncology |
| An internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2007. [7/1/2008: definiton added, source added; 7/1/2011: modified source] - Additional Resources: http://www.osteopathic.org/certification |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699035717 | Robert Dukjun Yoo | Internal Medicine | 1432 S Dobson Rd Ste 106, Mesa, AZ 85202 | 2012-05-22 |
| 1003821430 | Sanjeev Gopal | Internal Medicine | 6424 E Broadway Rd, 104-105, Mesa, AZ 85206-1750 | 2006-07-31 |
| 1437116985 | Harshita Reddy Paripati | Internal Medicine | 6424 E Broadway Rd Ste 104, Mesa, AZ 85206-1750 | 2006-04-27 |
| 1851912158 | Ironwood Physicians, PC | Internal Medicine | 6111 E Arbor Ave, Mesa, AZ 85206-6059 | 2020-04-28 |
| 1265873566 | Manisha Chandar | Internal Medicine | 6111 E Arbor Ave, Mesa, AZ 85206-6059 | 2013-07-15 |
| 1285952390 | Chad C Cherington | Internal Medicine | 1432 S Dobson Rd, Suite 106, Mesa, AZ 85202-4769 | 2010-05-13 |
| 1669703179 | Desert Oncology Associates LLP | Internal Medicine | 1432 S Dobson Rd, 106, Mesa, AZ 85202-4768 | 2010-01-22 |
| 1356508071 | Sumeet Kumar Mendonca Md PC | Internal Medicine | 1432 S Dobson Rd, 106, Mesa, AZ 85202-4768 | 2008-05-20 |
| 1477742534 | Christopher M Manus Md PC | Internal Medicine | 1432 S Dobson Rd, 106, Mesa, AZ 85202-4768 | 2007-10-15 |
| 1215134366 | Howard J Gold Md PC | Internal Medicine | 1432 S Dobson Rd, 106, Mesa, AZ 85202-4768 | 2007-07-02 |
| Find all providers in MESA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.