| Doctor Name: | DR. MICHAEL DAVID LONGE |
| NPI Number: | 1881817286 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MD |
| License Number: | 058273 |
| Business Practice Address: | 4350 Towne Centre Dr Suite 1000 Evans, GA - 308093301 |
| Business Phone Number: | 7068683940 |
| Business Fax Number: | |
| Mailing Address: | Po Box 3845, 1125 Troupe Street AUGUSTA |
| State: | GA |
| Postal Code: | 309143845 |
| Phone Number: | 7067374275 |
| Fax Number: | 7067315289 |
| NPI Enumeration Date: | 04/11/2007 |
| NPI Last Update Date: | 10/31/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2085B0100X |
| License Number: | 058273 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | GA |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Radiology |
| Taxonomy Specialization: | Body Imaging |
| Taxonomy Definition: | A Radiology doctor of Osteopathy that specializes in Body Imaging. |