Logan, Keith

Logan, Keith is an individual health care provider with primary practice located at 2701 Coltsgate Rd #105, Charlotte NC 28211-3534. He recently has only one registered license in Allopathic & Osteopathic Physicians / Psychiatry, which is considered as his primary health care specialty. Logan, Keith can be contacted via phone (704) 541-1213.

Contact Information

Primary practice address
2701 Coltsgate Rd #105 Charlotte NC 28211-3534
Phone: (704) 541-1213
Fax: (704) 541-4210
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Psychiatry 2084P0800X 9800612 North Carolina

Profile Details

NPI number 1134191463
LBN Legal business name Logan, Keith
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 2nd, 2006
Last updated Aug 5th, 2011 - about 13 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 1134191463 NPPES
North Carolina MEDICAID 891139V
North Carolina MEDICAID N00612

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