Dr Charlotte A Logan, MD | |
4201 Saint Antoine St, Detroit, MI 48201-2153 | |
(313) 745-3000 | |
Not Available |
Full Name | Dr Charlotte A Logan |
---|---|
Gender | Female |
Speciality | Emergency Medicine - Emergency Medical Services |
Location | 4201 Saint Antoine St, Detroit, Michigan |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1891756243 | NPI | - | NPPES |
104205740 | Medicaid | MI | |
104649020 | Medicaid | MI | |
104205730 | Medicaid | MI | |
1891756243 | Medicaid | IA | |
104317183 | Medicaid | MI | |
CL070300 | Other | MI | BC/BS OF MI |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207P00000X | Emergency Medicine | MD438501 (Pennsylvania) | Secondary |
207PE0004X | Emergency Medicine - Emergency Medical Services | 4301070300 (Michigan) | Primary |
Entity Name | Des Moines River Physicians Llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1720472442 PECOS PAC ID: 0143549634 Enrollment ID: O20150505001794 |
Mailing Address | Practice Location Address |
---|---|
Dr Charlotte A Logan, MD 18461 Woodingham Dr, Detroit, MI 48221-2155 Ph: () - | Dr Charlotte A Logan, MD 4201 Saint Antoine St, Detroit, MI 48201-2153 Ph: (313) 745-3000 |
Kristin Inger, M.D. Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 6071 W Outer Dr, Detroit, MI 48235 Phone: 313-966-3300 | |
Dr. Gerard Edward Heath, MD, MBA Emergency Medicine Medicare: Not Enrolled in Medicare Practice Location: 2799 W Grand Blvd, Detroit, MI 48202 Phone: 313-916-2600 | |
Dr. Robert T Malinowski, M.D. Emergency Medicine Medicare: Medicare Enrolled Practice Location: 6071 W Outer Dr, Detroit, MI 48235 Phone: 313-966-3300 | |
Dr. Kamal K Nangia, Emergency Medicine Medicare: Medicare Enrolled Practice Location: 3990 John R St, Detroit, MI 48201 Phone: 313-745-8040 | |
Dr. Matthew J Griffin, M.D. Emergency Medicine Medicare: Not Enrolled in Medicare Practice Location: 6071 W Outer Dr, Detroit, MI 48235 Phone: 313-966-3300 | |
Gregory L. Hays, M.D. Emergency Medicine Medicare: Not Enrolled in Medicare Practice Location: Henry Ford Health System, 2799 West Grand Boulevard, Detroit, MI 48202 Phone: 313-916-2436 | |
Brooke M Frakes, MD Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 6071 W Outer Dr, Detroit, MI 48235 Phone: 313-966-1024 |