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Individual
LOGAN HENRY FAIRCHILD
Active
Individual
LOGAN HENRY FAIRCHILD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
OS022631
PA
390200000X
Student in an Organized Health Care Education/Training Program
OT019238
PA
Other
Enumeration date
06/06/2019
Last updated
09/09/2024
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