Individual
DR. THEODORE P. LOGAN
Active
Individual
DR. THEODORE P. LOGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
012617
ME
2084A0401X
Addiction Medicine (Psychiatry & Neurology) Physician
MD12617
ME
2084P0800X
Psychiatry Physician
Primary
MD12617
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
047853
ANTHEM STAR NUMBER
ME
05
—
255750099
—
ME
Enumeration date
06/21/2005
Last updated
03/21/2017
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up