Logan, Theodore P.

Logan, Theodore P. is an individual health care provider with primary practice located at 12 Union St , Rockland ME 04841-2739. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatrics, Allopathic & Osteopathic Physicians / Psychiatry, Allopathic & Osteopathic Physicians / Addiction Medicine. Allopathic & Osteopathic Physicians / Psychiatry is his primary health care specialty. Logan, Theodore P. can be contacted via phone (207) 701-4400.

Contact Information

Primary practice address
12 Union St Rockland ME 04841-2739
Phone: (207) 701-4400
Fax: (207) 701-4487
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 012617 Maine
Allopathic & Osteopathic Physicians / Psychiatry 2084P0800X MD12617 Maine
Allopathic & Osteopathic Physicians / Addiction Medicine 2084A0401X MD12617 Maine

Profile Details

NPI number 1427054873
LBN Legal business name Logan, Theodore P.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 21st, 2005
Last updated Mar 21st, 2017 - about 7 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 1427054873 NPPES
Maine MEDICAID 255750099
Maine Other 047853

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