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Individual
LOGAN BOYER
Active
Individual
LOGAN BOYER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHYSICIAN ASSISTANT
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA00787
MS
363AS0400X
Surgical Physician Assistant
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—
Other
Enumeration date
02/02/2024
Last updated
08/21/2024
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