Logan, Mark Edward
Logan, Mark Edward is an individual health care provider with primary practice located at 199 Stratton Rd , Rutland VT 05701-4621. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Logan, Mark Edward can be contacted via phone (802) 775-7798.Contact Information
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 042-0006819 | Vermont |
Profile Details
| NPI number | 1184679227 |
|---|---|
| LBN Legal business name | Logan, Mark Edward |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 24th, 2006 |
| Last updated | Jun 9th, 2011 - about 15 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1184679227 | NPPES |
| Vermont | Other | 61-1488339 | TAX ID |
| Vermont | MEDICAID | 0005483 | TAX ID |
| Vermont | Other | 042-0006819 | TAX ID |
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