Organization
VILLAGE INTERNAL MEDICINE, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STEPHEN STUART LOGUE MD (PRESIDENT)
(910) 483-8080
Entity
Organization
Contact information
Practice address
1843 QUIET CV, FAYETTEVILLE, NC 28304-3857
(910) 483-8080
(910) 483-3258
Mailing address
1843 QUIET CV, FAYETTEVILLE, NC 28304-3857
(910) 483-8080
(910) 483-3258
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
62468
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
890296P
—
NC
Enumeration date
06/22/2006
Last updated
03/02/2010
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