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Individual

SAMUEL L OGDEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
109B ALLEN MEMORIAL DR, BREMEN, GA 30110-2009
(770) 537-4900
(770) 537-0907
Mailing address
109B ALLEN MEMORIAL DR, BREMEN, GA 30110-2009
(770) 537-4900
(770) 537-0907

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
O30170
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00400606A
GA
Enumeration date
10/10/2005
Last updated
01/25/2010
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