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

Primary practice address
199 Stratton Rd Rutland VT 05701-4621
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #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.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1184679227 NPPES
Vermont Other 61-1488339 TAX ID
Vermont MEDICAID 0005483 TAX ID
Vermont Other 042-0006819 TAX ID

Popular Providers