DR. TIMOTHY DAVID LOGAN (NPI# 1477763779) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1477763779 |
| Entity Type | Individual |
| Full Name | DR. TIMOTHY DAVID LOGAN |
| Credential | D.O. |
| Practice Address |
1000 Harrington St Mount Clemens MI 48043-2920 |
| Mailing Address |
21608 Englehardt St Saint Clair Shores MI 48080-2928 |
| Practice Telephone | 5864938000 |
| Mailing Telephone | 5862184088 |
| Enumeration Date | 2007-05-23 |
| Last Update Date | 2007-09-02 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
5101015334 | MI | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548227655 | Timothy W Logan | Dentist | 9800 Shelbyville Rd, Suite 202, Louisville, KY 40223-2977 | 2006-05-01 |
| Street Address |
1000 HARRINGTON ST |
| City | MOUNT CLEMENS |
| State | MI |
| Zip Code | 48043-2920 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255336335 | Richard L Reece Jr. | Internal Medicine | 1000 Harrington St, Mount Clemens, MI 48043-2920 | 2005-06-16 |
| 1033710116 | Mclaren Macomb | Rehabilitation Unit | 1000 Harrington St, Mount Clemens, MI 48043-2920 | 2020-11-04 |
| 1477154060 | Michael Dennie | Nurse Practitioner | 1000 Harrington St, Mount Clemens, MI 48043-2920 | 2020-11-02 |
| 1144828088 | Micayla Wehby | Nurse Practitioner | 1000 Harrington St, Mount Clemens, MI 48043-2920 | 2020-10-13 |
| 1326650516 | Dawn Miller | Social Worker | 1000 Harrington St, Mount Clemens, MI 48043-2920 | 2020-08-19 |
| 1437760246 | Sandeep Kaur | Internal Medicine | 1000 Harrington St, Mount Clemens, MI 48043-2920 | 2020-08-14 |
| 1538779475 | Kirandeep Sehmi | Internal Medicine | 1000 Harrington St, Mount Clemens, MI 48043-2920 | 2020-08-05 |
| 1669080172 | Anisha Tailor | Internal Medicine | 1000 Harrington St, Mount Clemens, MI 48043-2920 | 2020-07-21 |
| 1518575448 | Duncan George Innes | Family Medicine | 1000 Harrington St, Mount Clemens, MI 48043-2920 | 2020-07-16 |
| 1851909790 | John Murray | Family Medicine | 1000 Harrington St, Mount Clemens, MI 48043-2920 | 2020-07-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699300228 | Blue Diamond Aba Services LLC | Assistant Behavior Analyst | 102 North Avenue, Mt. Clemens, MI 48043 | 2020-03-04 |
| 1265086136 | Venture Counseling | Social Worker | 198 S. Main Street, Suite 2, Mount Clemens, MI 48043 | 2019-07-30 |
| 1386203651 | Michele Lee Casebolt | Physical Therapist | 30795 Twenty Three Mile Rd., Chesterfield, MI 48043 | 2019-06-11 |
| 1730669706 | Wynn A Mitchell | Case Manager/Care Coordinator | 24 Hubbard St, Mount Clemens, MI 48043 | 2018-08-18 |
| 1629520101 | Boitshoko Marang | Family Medicine | Clinton River Drive 11a, Mount Clemens, MI 48043 | 2016-10-31 |
| 1720332265 | New Passages | Point of Service | 175 N. Grorsebeck Hwy, Mt. Clemens, MI 48043 | 2012-11-06 |
| 1376807784 | Christopher John Shamass | Emergency Medicine | 1000 Harrington Boulevard, Mount Clemens, MI 48043 | 2012-06-29 |
| 1265749683 | Mycare Health Center | Clinic/Center | 18 Market Street, Suite C, Mount Clemens, MI 48043 | 2010-09-07 |
| 1114102837 | George Edward Perron | Family Medicine | 256 Wellington Crescent, Mt Clemens, MI 48043 | 2007-12-31 |
| 1558568733 | Dawood Ghassan Dalaly | Surgery | 1000 Harrington, Mt Clemens, MI 48043 | 2007-06-29 |
| Find all providers in zip 48043 | ||||
| Taxonomy Code | 207RC0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Cardiovascular Disease |
| An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2008 [7/1/2008: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, http://www.abim.org/. American Osteopathic Board of Internal Medicine, https://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518000223 | General Hosp Medical Assoc, P.C. | Internal Medicine | 1030 Harrington St Ste 101, Mount Clemens, MI 48043-2967 | 2007-02-14 |
| 1245477108 | Firas Yazigi | Internal Medicine | 133 S Main St, Mount Clemens, MI 48043-2308 | 2009-01-14 |
| 1750544268 | Sibin K Zacharias | Internal Medicine | 1030 Harrington St, Ste 101, Mount Clemens, MI 48043-2967 | 2008-07-03 |
| 1528258654 | Mclaren Macomb | Internal Medicine | 1000 Harrington St, Mount Clemens, MI 48043 | 2007-07-25 |
| 1801005145 | Natesh Lingam | Internal Medicine | 133 S Main St, Mount Clemens, MI 48043-2308 | 2007-05-22 |
| 1407066350 | Vijay Ravin Patel | Internal Medicine | 133 S Main St, Mount Clemens, MI 48043-2308 | 2007-05-22 |
| 1487861043 | Michael Blair Deyoung | Internal Medicine | 1000 Harrington Blvd., Mount Clemens, MI 48043-2920 | 2007-05-16 |
| 1538141262 | Brian Michael Litch | Internal Medicine | 1030 Harrington St, Suite 101, Mount Clemens, MI 48043-2967 | 2005-11-17 |
| 1508848748 | Larry Robert Rothstein | Internal Medicine | 1030 Harrington St, Suite 101, Mount Clemens, MI 48043-2967 | 2005-11-15 |
| 1487636635 | Beth Ann Bowling | Internal Medicine | 1030 Harrington St, Ste 101, Mount Clemens, MI 48043-2967 | 2005-11-15 |
| Find all providers in MOUNT CLEMENS | ||||
| City | MOUNT CLEMENS |
| Zip Code | 48043 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.