Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | 5101013461 | MI |
NPI | 1013001890 |
---|---|
Provider Name | Dr. Melissa P Pieroni Long |
First Address | East Lansing, MI 48823-1437 |
Second Address | East Lansing, MI 48823-1437 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/10/2006 |
Last Update Date | 25/11/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
114233548 | (05) | MI |