Provider Demographics
NPI:1962493650
Name:LE, LONG HOANG (MD)
Entity Type:Individual
Prefix:MR
First Name:LONG
Middle Name:HOANG
Last Name:LE
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Gender:M
Credentials:MD
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Mailing Address - Street 1:3180 N POINT PKWY
Mailing Address - Street 2:BLDG. 200 SUITE #201
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30005-4248
Mailing Address - Country:US
Mailing Address - Phone:770-777-9845
Mailing Address - Fax:770-777-9846
Practice Address - Street 1:3180 N POINT PKWY
Practice Address - Street 2:BLDG. 200 SUITE #201
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30005-4248
Practice Address - Country:US
Practice Address - Phone:770-777-9845
Practice Address - Fax:770-777-9846
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-02
Last Update Date:2011-08-25
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Provider Licenses
StateLicense IDTaxonomies
GA044770207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
G60349Medicare UPIN
GA11BDRPPMedicare ID - Type Unspecified