Samuel Ernest Logan M.D., PHD

NPI 1013914241 - Plastic Surgery - 2082S0105X

NPI Details
NPI 1013914241
Gender Male
Enumeration Date 07/01/2005
Last Updated 04/14/2010
Entity Type Individual
Active Over 11 years ago
Practice Location
3901 STONEGATE PARK
SUITE 300
SAINT JOSEPH MI, 49085-9137, US
Phone (269) 556-6000
Fax (269) 556-6020
Business Location
1875 BOARDWALK
SAINT JOSEPH MI, 49085-9664, US
Phone (269) 428-7878
Fax
Toxanomy
Taxonomy Code 2082S0105X
License State Michigan
License Number 4301056980
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According to our database, Dr. Samuel Ernest Logan M.D., PHD NPI is 1013914241, taxonomy code is 2082S0105X and license number is 4301056980, license state is located at Michigan. Samuel Ernest Logan M.D., PHD physically located at 3901 Stonegate Park, Saint Joseph MI, 49085-9137. NPI Number Samuel Ernest Logan M.D., PHD has the Individual type.

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1013914241 NPI number is provided on an as is basis without warranty of any kind. 1013914241 is maintained by the National Plan & Provider Enumeration System. The contents of Samuel Ernest Logan M.D., PHD are for informational purposes only.