Individual
LOGAN DISHAWN MATHUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTT
Contact information
Practice address
2480 LLEWELLYN AVE, FORT MEADE, MD 20755-7081
(301) 677-8796
Mailing address
4755 ENGLISH AVE UNIT G2, FORT GEORGE G MEADE, MD 20755-2177
(754) 235-1328
Taxonomy
Speciality
Code
Description
License number
State
171000000X
Military Health Care Provider
Primary
—
—
Other
Enumeration date
07/01/2024
Last updated
07/01/2024
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