Individual
ALEXANDER C LOGAN III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3655 MITCHELL ST, DEPARTMENT OF PATHOLOGY, LORIS, SC 29569-2827
(843) 716-7000
(843) 716-7272
Mailing address
PO BOX 3099, MYRTLE BEACH, SC 29578-3099
(843) 716-7000
(843) 716-7272
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
14453
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
144539
—
SC
05
—
690543P
—
NC
Enumeration date
01/17/2006
Last updated
08/07/2012
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