| Michael J. Logan Md, Sc | |
|
16535 W Bluemound Rd Ste 200 Brookfield WI 53005-5906 | |
| (262) 789-0909 | |
| (262) 821-6180 |
| Full Name | Michael J. Logan Md, Sc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 16535 W Bluemound Rd Ste 200, Brookfield, Wisconsin |
| Authorized Official Name and Position | Michael Jeffrey Logan (OWNER/PRESIDENT) |
| Authorized Official Contact | 2627861710 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Michael J. Logan Md, Sc 15065 Westover Rd Elm Grove WI 53122-1541 Ph: (262) 786-1710 | Michael J. Logan Md, Sc 16535 W Bluemound Rd Ste 200 Brookfield WI 53005-5906 Ph: (262) 789-0909 |
| NPI Number | 1093017196 |
|---|---|
| Provider Enumeration Date | 11/22/2010 |
| Last Update Date | 11/22/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093017196 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | 16418-20 (Wisconsin) | Primary |
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