Provider Demographics
NPI:1487547741
Name:LONGIE, ALISON MAE (MD)
Entity type:Individual
Prefix:
First Name:ALISON
Middle Name:MAE
Last Name:LONGIE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4820 23RD AVE S STE 200
Mailing Address - Street 2:
Mailing Address - City:FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58104-9138
Mailing Address - Country:US
Mailing Address - Phone:701-293-4113
Mailing Address - Fax:701-293-4113
Practice Address - Street 1:4820 23RD AVE S STE 200
Practice Address - Street 2:
Practice Address - City:FARGO
Practice Address - State:ND
Practice Address - Zip Code:58104-9138
Practice Address - Country:US
Practice Address - Phone:701-293-4113
Practice Address - Fax:701-293-4113
Is Sole Proprietor?:No
Enumeration Date:2025-06-03
Last Update Date:2025-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program