Logan, Charlotte A

Logan, Charlotte A is an individual health care provider with primary practice located at 4201 Saint Antoine St , Detroit MI 48201-2153. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Emergency Medicine, Allopathic & Osteopathic Physicians / Emergency Medical Services. Allopathic & Osteopathic Physicians / Emergency Medical Services is her primary health care specialty. Logan, Charlotte A can be contacted via phone (313) 745-3000.

Contact Information

Primary practice address
4201 Saint Antoine St Detroit MI 48201-2153
Phone: (313) 745-3000
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X MD438501 Pennsylvania
Allopathic & Osteopathic Physicians / Emergency Medical Services 207PE0004X 4301070300 Michigan

Profile Details

NPI number 1891756243
LBN Legal business name Logan, Charlotte A
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 28th, 2006
Last updated Aug 22nd, 2019 - about 5 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 1891756243 NPPES
Michigan MEDICAID 104205740
Michigan MEDICAID 104649020
Michigan MEDICAID 104205730
Michigan MEDICAID 1891756243
Michigan MEDICAID 104317183
Michigan Other CL070300

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