Individual
LOGAN ROBERT GODFREY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1 MEDICAL CENTER DR, MORGANTOWN, WV 26506-1200
(304) 293-3092
Mailing address
PO BOX 9235, MORGANTOWN, WV 26506-9235
(304) 293-3092
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
1491
WV
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/22/2022
Last updated
07/04/2023
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