| Doctor Name: | DR. SAMUEL ERNEST LOGAN |
| NPI Number: | 1013914241 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.D., PHD |
| License Number: | 4301056980 |
| Business Practice Address: | 3901 Stonegate Park Suite 300 Saint Joseph, MI - 490859137 |
| Business Phone Number: | 2695566000 |
| Business Fax Number: | 2695566020 |
| Mailing Address: | 1875 Boardwalk, SAINT JOSEPH |
| State: | MI |
| Postal Code: | 490859664 |
| Phone Number: | 2694287878 |
| Fax Number: | |
| NPI Enumeration Date: | 07/01/2005 |
| NPI Last Update Date: | 04/14/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2082S0105X |
| License Number: | 4301056980 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | MI |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Plastic Surgery |
| Taxonomy Specialization: | Surgery of the Hand |
| Taxonomy Definition: | A plastic surgeon with additional training in the investigation, preservation, and restoration by medical, surgical and rehabilitative means of all structures of the upper extremity directly affecting the form and function of the hand and wrist. |