Logan, Casey Douglas
Logan, Casey Douglas is an individual health care provider with primary practice located at 2790 Mosside Blvd Ste 720 , Monroeville PA 15146-2757. He recently has only one registered license in Allopathic & Osteopathic Physicians / Dermatology, which is considered as his primary health care specialty. Logan, Casey Douglas can be contacted via phone (412) 372-2770.Contact Information
Primary practice address
2790 Mosside Blvd Ste 720
Monroeville PA 15146-2757
Phone: (412) 372-2770
Fax: (412) 372-4656
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Dermatology | 207N00000X | MD479164 | Pennsylvania |
Profile Details
| NPI number | 1245727692 |
|---|---|
| LBN Legal business name | Logan, Casey Douglas |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 20th, 2018 |
| Last updated | Jan 13th, 2023 - about last year |
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 | 1245727692 | NPPES |
| Pennsylvania | MEDICAID | 1040784250002 | |
| Pennsylvania | MEDICAID | 1040784250001 |
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