Organization
DREW H. LOGUE, M.D., INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DREW H. LOGUE M.D. (CEO)
(209) 578-3170
Entity
Organization
Contact information
Practice address
1329 SPANOS CT, SUITE C-3, MODESTO, CA 95355-2806
(209) 578-3170
(209) 529-4151
Mailing address
1329 SPANOS CT, SUITE C-3, MODESTO, CA 95355-2806
(209) 578-3170
(209) 529-4151
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
A25519
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
290011015
RAILROAD MEDICARE
CA
Enumeration date
08/21/2006
Last updated
09/03/2010
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