Individual
LOGAN DONEVANT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CAA
Contact information
Practice address
11705 MERCY BLVD, SAVANNAH, GA 31419-1711
(912) 819-4100
Mailing address
5719 PICKENS AVE, MYRTLE BEACH, SC 29577-2223
(843) 360-9923
Taxonomy
Speciality
Code
Description
License number
State
367H00000X
Anesthesiologist Assistant
Primary
8994
GA
Other
Enumeration date
09/03/2018
Last updated
08/21/2023
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