Individual
DR. TIMOTHY DAVID LOGAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1000 HARRINGTON ST, MOUNT CLEMENS, MI 48043-2920
(586) 493-8000
Mailing address
21608 ENGLEHARDT ST, SAINT CLAIR SHORES, MI 48080-2928
(586) 218-4088
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
5101015334
MI
Other
Enumeration date
05/23/2007
Last updated
09/02/2007
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