Individual
LOGAN EDWARD MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN (DNP - STUDENT)
Contact information
Practice address
2480 LLEWELLYN AVE, FORT MEADE, MD 20755-7081
(301) 667-8800
Mailing address
4301 JONES BRIDGE RD, BETHESDA, MD 20814-4799
(800) 515-5257
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
07/16/2024
Last updated
07/16/2024
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