Individual
LOGAN HERBERT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3950 AUSTELL RD, AUSTELL, GA 30106-1121
(770) 732-4000
Mailing address
5665 NEW NORTHSIDE DR STE 320, ATLANTA, GA 30328-5834
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
92104
GA
390200000X
Student in an Organized Health Care Education/Training Program
—
MI
Other
Enumeration date
06/04/2018
Last updated
06/08/2022
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