Individual provider · NPI-1

Logan Burtenshaw, DO

Dermatology · Dearborn, MI

NPI number1801733506
StatusActive
Last updated in NPPESApr 30, 2026

Details

NPI
1801733506
Entity type
Individual (NPI-1)
Name
Logan Burtenshaw
Credential
DO
Sex
Male
Sole proprietor
Yes
Enumeration date
Apr 30, 2026
Certification date
Apr 30, 2026
Last updated
Apr 30, 2026

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207N00000X Dermatology5151018096MIYes

Practice location

18101 Oakwood Blvd
Dearborn, MI 48124-4089

Phone 313-593-7000

Mailing address

18101 Oakwood Blvd
Dearborn, MI 48124-4089

Phone 313-593-7000

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