DR. SAMUEL ERNEST LOGAN M.D., PHD

Surgery Yellow Pages

Saint Joseph, Michigan

Provider NPI: 1013914241

Provider Information:
DR. SAMUEL ERNEST LOGAN M.D., PHD


Practice Location:
3901 STONEGATE PARK SUITE 300 SAINT JOSEPH, MI 49085 US
Tel: 269-556-6000  Fax: --

Business Mailing Address:
  ,   
Tel: --  Fax: --


Taxonomy:

Primary	Code	Category/Description	State	License Number
Y	208200000X	Physicians Plastic Surgery	MI	4301056980
N	2082S0105X	Physicians Plastic Surgery	MI	4301056980
N	174400000X	Other Service Providers Specialist	MI	4301056980

Other Provider Identifiers:

Issuer	Number	State	Type
	1013914241	MI	05
	2663684	MI	05

Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin