Individual
DR. LOGAN MICHAEL SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2709 BLUE RIDGE RD STE 100, RALEIGH, NC 27607-6462
(919) 782-5400
Mailing address
2709 BLUE RIDGE RD STE 100, RALEIGH, NC 27607-6462
(919) 782-5400
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
67797
TN
207WX0009X
Glaucoma Specialist (Ophthalmology) Physician
Primary
2024-01420
NC
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/14/2019
Last updated
06/18/2024
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