Provider Demographics
NPI:1407945405
Name:LONG, CINDY E (MD)
Entity Type:Individual
Prefix:
First Name:CINDY
Middle Name:E
Last Name:LONG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9195 GRANT ST
Mailing Address - Street 2:SUITE 300
Mailing Address - City:THORNTON
Mailing Address - State:CO
Mailing Address - Zip Code:80229-4385
Mailing Address - Country:US
Mailing Address - Phone:303-280-2229
Mailing Address - Fax:303-280-0765
Practice Address - Street 1:9195 GRANT ST
Practice Address - Street 2:SUITE 300
Practice Address - City:THORNTON
Practice Address - State:CO
Practice Address - Zip Code:80229-4385
Practice Address - Country:US
Practice Address - Phone:303-280-2229
Practice Address - Fax:303-280-0765
Is Sole Proprietor?:No
Enumeration Date:2006-10-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO38836207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO36109754Medicaid
H25109Medicare UPIN
297238Medicare ID - Type Unspecified