| Dr Mark Edward Logan, MD | |
|
199 Stratton Rd, Rutland, VT 05701-4621 | |
| (802) 775-7798 | |
| Not Available |
| Full Name | Dr Mark Edward Logan |
|---|---|
| Gender | Male |
| Speciality | Addiction Medicine |
| Experience | 46 Years |
| Location | 199 Stratton Rd, Rutland, Vermont |
| Accepts Medicare Assignments | May be. He may accept the Medicare-approved amount; you may be billed for more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184679227 | NPI | - | NPPES |
| 61-1488339 | Other | VT | TAX ID |
| 0005483 | Medicaid | VT | |
| 042-0006819 | Other | VT | LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 042-0006819 (Vermont) | Primary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Connecticut Valley Addiction Recovery Inc | 1850710179 | 4 |
| Entity Name | Connecticut Valley Addiction Recovery Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1750932646 PECOS PAC ID: 1850710179 Enrollment ID: O20201006000289 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Mark Edward Logan, MD 199 Stratton Rd, Rutland, VT 05701-4621 Ph: (802) 775-7798 | Dr Mark Edward Logan, MD 199 Stratton Rd, Rutland, VT 05701-4621 Ph: (802) 775-7798 |
Michael William Gleeson, MD, PHD Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 1 Albert Cree Dr, Rutland, VT 05701 Phone: 802-786-1400 Fax: 802-786-1405 | |
Sudhir Babu Movva, M.D Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 160 Allen St, Rutland, VT 05701 Phone: 802-747-1633 Fax: 802-775-7214 | |
Carolina Mendes Pessoa, MD Internal Medicine Medicare: Medicare Enrolled Practice Location: 8 Albert Cree Dr, Rutland, VT 05701 Phone: 802-775-7844 | |
T Ray Lovko, M.D. Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 215 Stratton Rd, Rutland, VT 05701 Phone: 802-773-3386 Fax: 802-773-4578 | |
Dr. Louis Block Meyers, M.D. Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 160 Allen St, Rutland, VT 05701 Phone: 802-775-7111 Fax: 802-772-2556 | |
Mark C Stickney, M.D. Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 3 Commons St, Rutland, VT 05701 Phone: 802-773-7155 Fax: 802-773-7616 |