Provider Demographics
NPI:1508898651
Name:FURLONG, JAMES W (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:W
Last Name:FURLONG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:PO BOX 55114
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48255
Mailing Address - Country:US
Mailing Address - Phone:248-858-3197
Mailing Address - Fax:248-858-3148
Practice Address - Street 1:44405 WOODWARD AVENUE
Practice Address - Street 2:ST JOSEPH MERCY HOSPITAL
Practice Address - City:PONTIAC
Practice Address - State:MI
Practice Address - Zip Code:48341-2985
Practice Address - Country:US
Practice Address - Phone:248-858-3190
Practice Address - Fax:248-858-3148
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI049755207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1740869Medicaid
MI1740869Medicaid