| Logan Internal Medicine Group | |
|
77 Hospital Drive Suite 101 Logan WV 25601-3451 | |
| (304) 831-0450 | |
| (304) 831-0452 |
| Full Name | Logan Internal Medicine Group |
|---|---|
| Speciality | Internal Medicine |
| Location | 77 Hospital Drive, Logan, West Virginia |
| Authorized Official Name and Position | Fernando Luis Gonzalez-ramos (CEO) |
| Authorized Official Contact | 3048310450 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Logan Internal Medicine Group Po Box 1617 Logan WV 25601-1617 Ph: (304) 831-0450 | Logan Internal Medicine Group 77 Hospital Drive Suite 101 Logan WV 25601-3451 Ph: (304) 831-0450 |
| NPI Number | 1730117896 |
|---|---|
| Provider Enumeration Date | 06/29/2006 |
| Last Update Date | 02/10/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730117896 | NPI | - | NPPES |
| 3810011047 | Medicaid | WV | |
| 001860338 | Other | BCBS OF MICHIGAN | |
| 001860338 | Other | MOUNTAIN STATE BCBS | |
| DF2728 | Other | WV | RR MEDICARE |
| 438170 | Other | ADVANTRA FREEDOM | |
| 438170 | Other | COVENTRY HEALTH | |
| 611399500 | Other | BLACK LUNG |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
Carlton L W Herald Do Pc Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 77 Hospital Dr, Suite 100, Logan, WV 25601 Phone: 304-831-2061 Fax: 304-831-2063 | |
Southern West Virgina Health System-logan Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 122 Nick Savas Drive, Logan, WV 25601 Phone: 304-752-8081 Fax: 304-752-8083 | |
Legacy Family Medicine Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 214 Hanging Rock Hwy, Logan, WV 25601 Phone: 304-784-4495 Fax: 304-688-9020 | |
Main Street Family Practice, Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 533 Main St, Logan, WV 25601 Phone: 304-752-3400 Fax: 304-752-8138 | |
Ovp Health Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 557 Main St, Logan, WV 25601 Phone: 740-752-3435 Fax: 740-753-3436 | |
Absolute Care Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 112 Bridge St, Logan, WV 25601 Phone: 304-896-5025 Fax: 304-896-5058 | |
Living Waters Medical Center Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 100 Main Ave, Logan, WV 25601 Phone: 304-946-8350 |