Provider Demographics
NPI:1194011676
Name:LONG, LINDSEY ANN (MD)
Entity type:Individual
Prefix:DR
First Name:LINDSEY
Middle Name:ANN
Last Name:LONG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:LINDSEY
Other - Middle Name:A
Other - Last Name:LOEW
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:4343 CONCOURSE DR STE 150
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48108-8672
Mailing Address - Country:US
Mailing Address - Phone:734-780-9907
Mailing Address - Fax:734-345-1013
Practice Address - Street 1:4343 CONCOURSE DR STE 150
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48108-8672
Practice Address - Country:US
Practice Address - Phone:734-780-9907
Practice Address - Fax:734-345-1013
Is Sole Proprietor?:No
Enumeration Date:2011-06-23
Last Update Date:2025-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301098357208000000X, 390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program