Individual
DORA D LOGUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
707 N BROADWAY, BALTIMORE, MD 21205-1832
(443) 923-9200
(443) 923-9405
Mailing address
2931 E BIDDLE ST, PATIENT ACCOUNTING, BALTIMORE, MD 21213-3939
(443) 923-1886
(443) 923-1895
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
D0006573
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
33087304
CAREFIRST BC BS
MD
05
—
438481400
—
MD
Enumeration date
01/29/2007
Last updated
10/15/2012
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