Provider Demographics
NPI:1851385934
Name:LONG, FRANK E (MD)
Entity Type:Individual
Prefix:DR
First Name:FRANK
Middle Name:E
Last Name:LONG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 MEDICAL PARK DR
Mailing Address - Street 2:SUITE 250 CABARRUS OB/GYNA
Mailing Address - City:CONCORD
Mailing Address - State:NC
Mailing Address - Zip Code:28025-2982
Mailing Address - Country:US
Mailing Address - Phone:704-403-2740
Mailing Address - Fax:704-403-2744
Practice Address - Street 1:200 MEDICAL PARK DR
Practice Address - Street 2:SUITE 250 CABARRUS OB/GYN
Practice Address - City:CONCORD
Practice Address - State:NC
Practice Address - Zip Code:28025-2982
Practice Address - Country:US
Practice Address - Phone:704-403-2740
Practice Address - Fax:704-403-2744
Is Sole Proprietor?:No
Enumeration Date:2005-09-06
Last Update Date:2009-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC20667174400000X, 207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC232009OtherMEDICARE PIN-GROUP
NC8952584Medicaid
NC208316Medicare ID - Type Unspecified
NC208316BMedicare PIN
NC8952584Medicaid