Individual
DR. SAMUEL ERNEST LOGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D., PHD
Contact information
Practice address
3901 STONEGATE PARK, SUITE 300, SAINT JOSEPH, MI 49085-9137
(269) 556-6000
(269) 556-6020
Mailing address
3901 STONEGATE PARK, SUITE 300, SAINT JOSEPH, MI 49085-9137
(269) 556-6000
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
4301056980
MI
208200000X
Plastic Surgery Physician
Primary
4301056980
MI
2082S0105X
Surgery of the Hand (Plastic Surgery) Physician
4301056980
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1013914241
—
MI
05
—
2663684
—
MI
Enumeration date
07/01/2005
Last updated
01/31/2017
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