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Contact Information

SAMUEL E LOGAN, M.D., PHD
3901 STONEGATE PARK
SUITE 300
SAINT JOSEPH, MI49085-9137
 Phone: 269-556-6000
 Fax: 269-556-6020
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Plastic Surgery

208200000X 02 Physician/General Surgery
 

Specialist

174400000X
 

Surgery of the Hand

2082S0105X 02 Physician/General Surgery
Indicates primary specialty

NPI Profile & details for SAMUEL E LOGAN · (Male)

NPI Number 1013914241
Status Active
Credentials M.D., PHD
Entity Individual
Enumeration date 07/01/2005
Last updated 01/31/2017 - About 9 years ago
Sole proprietor 1 No
Identifiers
  • MI License # 4301056980
  • MI Medicaid 1013914241
  • MI Medicaid 2663684
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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