Individual
DR. STEPHEN S LOGUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1843 QUIET CV, FAYETTEVILLE, NC 28304-3857
(910) 483-8080
(910) 483-3258
Mailing address
1843 QUIET CV, FAYETTEVILLE, NC 28304-3857
(910) 483-8080
(910) 483-3258
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
00-25971
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8952494
—
NC
Enumeration date
07/03/2006
Last updated
03/02/2010
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