Dr. Logan Peter Smith, MD
Student in an Organized Health Care Education/Training Program in Staten Island, NY. Individual provider (NPI-1).
NPI number1295438596
StatusActive
Last updated in NPPESMar 24, 2023
Details
- NPI
- 1295438596
- Entity type
- Individual (NPI-1)
- Name
- Dr. Logan Peter Smith
- Credential
- MD
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Mar 24, 2023
- Certification date
- Mar 24, 2023
- Last updated
- Mar 24, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 390200000X | Student in an Organized Health Care Education/Training Program | – | – | Yes |
Practice location
475 Seaview AveStaten Island, NY 10305-3436
Phone 718-226-8630
Mailing address
475 Seaview AveStaten Island, NY 10305-3436
Phone 718-226-8630
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