Individual
MACDONALD B LOGIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3635 VISTA, ST LOUIS, MO 63110
(314) 577-8815
(314) 268-5106
Mailing address
3691 RUTGER AVE, PROVIDER ENROLLMENT, ST LOUIS, MO 63110
(314) 977-4440
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
32088
MO
Other
Enumeration date
07/20/2006
Last updated
01/09/2008
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