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Individual

CYNTHIA A LOGAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
125 VANCE HILL DR, MILLS RIVER, NC 28759
(828) 891-7522
(828) 891-7523
Mailing address
PO BOX 1869, FLETCHER, NC 28732-1869
(828) 687-5698
(828) 650-8076

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
0101222161
VA
207Q00000X
Family Medicine Physician
Primary
2016-01589
NC
207Q00000X
Family Medicine Physician
42113
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1306817259
VA
05
3000080
TN
01
P01081173
RR MEDICARE
VA
Enumeration date
01/30/2006
Last updated
04/15/2019
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