Individual
DR. DONALD R LOGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
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
Update your record
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