Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207T00000X | Neurosurgeon | 35051273 | OH |
NPI | 1023124377 |
---|---|
Provider Name | Dr. Sean Raymond Logan |
First Address | Lima, OH 45804-4030 |
Second Address | Findlay, OH 45840-5463 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/08/2006 |
Last Update Date | 17/03/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0875683 | (05) | OH |
F27523 | (02) | OH |