Individual
DR. LOGAN PHILLIP GRIMES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3401 CIVIC CENTER BLVD RM DIVISION, PHILADELPHIA, PA 19104-4319
(215) 590-2017
Mailing address
3401 CIVIC CENTER BLVD RM 55, PHILADELPHIA, PA 19104-4319
(215) 590-1220
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
MD475081
PA
2080P0208X
Pediatric Infectious Diseases Physician
Primary
MD475081
PA
Other
Enumeration date
06/13/2018
Last updated
09/26/2024
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