Dr Mark Edward Logan, MD | |
199 Stratton Rd, Rutland, VT 05701-4621 | |
(802) 775-7798 | |
Not Available |
Full Name | Dr Mark Edward Logan |
---|---|
Gender | Male |
Speciality | Internal Medicine |
Location | 199 Stratton Rd, Rutland, Vermont |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1184679227 | NPI | - | NPPES |
61-1488339 | Other | VT | TAX ID |
0005483 | Medicaid | VT | |
042-0006819 | Other | VT | LICENSE |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | 042-0006819 (Vermont) | Primary |
Entity Name | Connecticut Valley Addiction Recovery Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1750932646 PECOS PAC ID: 1850710179 Enrollment ID: O20201006000289 |
Mailing Address | Practice Location Address |
---|---|
Dr Mark Edward Logan, MD 199 Stratton Rd, Rutland, VT 05701-4621 Ph: (802) 775-7798 | Dr Mark Edward Logan, MD 199 Stratton Rd, Rutland, VT 05701-4621 Ph: (802) 775-7798 |
Michael William Gleeson, MD, PHD Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 1 Albert Cree Dr, Rutland, VT 05701 Phone: 802-786-1400 Fax: 802-786-1405 | |
Sudhir Babu Movva, M.D Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 160 Allen St, Rutland, VT 05701 Phone: 802-747-1633 Fax: 802-775-7214 | |
T Ray Lovko, M.D. Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 215 Stratton Rd, Rutland, VT 05701 Phone: 802-773-3386 Fax: 802-773-4578 | |
Dr. Louis Block Meyers, M.D. Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 160 Allen St, Rutland, VT 05701 Phone: 802-775-7111 Fax: 802-772-2556 | |
William Orourke, M.D. Internal Medicine Medicare: Not Enrolled in Medicare Practice Location: 69 Allen St, Suite 11, Rutland, VT 05701 Phone: 802-775-0033 | |
Mark C Stickney, M.D. Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 3 Commons St, Rutland, VT 05701 Phone: 802-773-7155 Fax: 802-773-7616 |