Logan, Samuel Ernest

Logan, Samuel Ernest is an individual health care provider with primary practice located at 3901 Stonegate Park Suite 300, Saint Joseph MI 49085-9137. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Plastic Surgery, Allopathic & Osteopathic Physicians / Surgery of the Hand, Other Service Providers / Specialist. Allopathic & Osteopathic Physicians / Plastic Surgery is his primary health care specialty. Logan, Samuel Ernest can be contacted via phone (269) 556-6000.

Contact Information

Primary practice address
3901 Stonegate Park Suite 300 Saint Joseph MI 49085-9137
Phone: (269) 556-6000
Fax: (269) 556-6020
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Plastic Surgery 208200000X 4301056980 Michigan
Allopathic & Osteopathic Physicians / Surgery of the Hand 2082S0105X 4301056980 Michigan
Other Service Providers / Specialist 174400000X 4301056980 Michigan

Profile Details

NPI number 1013914241
LBN Legal business name Logan, Samuel Ernest
Credentials M.D., PHD
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 1st, 2005
Last updated Jan 31st, 2017 - about 8 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1013914241 NPPES
Michigan MEDICAID 2663684
Michigan MEDICAID 1013914241

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