Individual
GEORGE LOGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
6500 EXCELSIOR BLVD, ST LOUIS PARK, MN 55426-4702
(952) 993-3240
Mailing address
8170 33RD AVE S # MS 21110Q, BLOOMINGTON, MN 55425-4516
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
27697
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
766867800
—
MN
Enumeration date
11/29/2005
Last updated
09/01/2021
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