Individual
DR. LOGAN GABRIEL GRADDY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
910 BROAD ST, DURHAM, NC 27705-4142
(919) 416-4191
(888) 805-6175
Mailing address
910 BROAD ST, DURHAM, NC 27705-4142
(919) 416-4191
(888) 805-6175
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
2007-00070
NC
2084P0802X
Addiction Psychiatry Physician
2007-00070
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5911215
—
NC
Enumeration date
02/20/2008
Last updated
07/16/2013
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