Individual
BRENT A LOGIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
9376 ATLEE STATION RD, HANOVER FAMILY PHYSICIANS PC, MECHANICSVILLE, VA 23116-2602
(804) 730-0990
(804) 730-8752
Mailing address
9376 ATLEE STATION RD, HANOVER FAMILY PHYSICIANS PC, MECHANICSVILLE, VA 23116-2602
(804) 730-0990
(804) 730-8752
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0101235776
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010176719
—
VA
Enumeration date
08/15/2006
Last updated
12/16/2021
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