Individual
DR. DONALD R LOGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
703 RIVERWAY PL, BEDFORD, NH 03110-6768
(603) 668-7096
(603) 669-6944
Mailing address
703 RIVERWAY PL, BEDFORD, NH 03110-6768
(603) 668-7096
(603) 669-6944
Taxonomy
Speciality
Code
Description
License number
State
2085B0100X
Body Imaging Physician
Primary
10868
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
010868
TUFTS
NH
01
—
01Y002303 NH05
ANTHEM-MCH TAX ID
NH
01
—
01Y002303NH02
BLUE CROSS
NH
01
—
2285319
AETNA
NH
01
—
294662
CIGNA
NH
05
—
30200557
—
NH
Enumeration date
04/17/2006
Last updated
07/08/2007
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