DR. SAMUEL ERNEST LOGAN (NPI# 1013914241) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1013914241 |
| Entity Type | Individual |
| Full Name | DR. SAMUEL ERNEST LOGAN |
| Credential | M.D., PHD |
| Practice Address |
3901 Stonegate Park Suite 300 Saint Joseph MI 49085-9137 |
| Practice Telephone | 2695566000 |
| Practice Fax Number | 2695566020 |
| Mailing Telephone | 2695566000 |
| Enumeration Date | 2005-07-01 |
| Last Update Date | 2017-01-31 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 174400000X | Specialist | 4301056980 | MI | Other Service Providers |
| Y | 208200000X | Plastic Surgery | 4301056980 | MI | Allopathic & Osteopathic Physicians |
| N | 2082S0105X |
Plastic Surgery Specialization: Surgery of the Hand |
4301056980 | MI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | 1013914241 | 05 | |
| MI | 2663684 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417586173 | Samuel Logan | Student in an Organized Health Care Education/Training Program | 101 W 8th Ave, Spokane, WA 99204-2307 | 2020-04-05 |
| 1386012482 | Samuel Logan | Nurse Practitioner | 800 Biesterfield Rd, Elk Grove Village, IL 60007-3361 | 2015-09-04 |
| 1699059659 | Samuel Logan | Case Manager/Care Coordinator | 350 E Gobbi St, Ukiah, CA 95482-5511 | 2011-10-07 |
| Street Address |
3901 STONEGATE PARK SUITE 300 |
| City | SAINT JOSEPH |
| State | MI |
| Zip Code | 49085-9137 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922557347 | Lakeland Medical Practices | Dermatology | 3901 Stonegate Park, Suite 300, Saint Joseph, MI 49085-9137 | 2016-09-27 |
| 1417324393 | Lakeland Medical Practices | Surgery | 3901 Stonegate Park, Suite 300, Saint Joseph, MI 49085-9137 | 2015-08-27 |
| 1255525697 | American Limb & Orthopedic Co. | Prosthetic/Orthotic Supplier | 3901 Stonegate Park, Suite 200, Saint Joseph, MI 49085-9137 | 2007-08-29 |
| 1538370135 | Gordon Sanghi Won | Dentist | 3901 Stonegate Park, Ste 100, Saint Joseph, MI 49085-9137 | 2007-05-24 |
| 1558570580 | Karen Lynne Powers | Plastic Surgery | 3901 Stonegate Park, Suite 300, Saint Joseph, MI 49085-9137 | 2007-05-22 |
| 1568504397 | Riddhi Jay Shah | Dermatology | 3901 Stonegate Park, Suite 300, Saint Joseph, MI 49085-9137 | 2007-02-12 |
| 1578655270 | Christina Diane Pareigis | Physical Medicine & Rehabilitation | 3901 Stonegate Park, Suite #500, Saint Joseph, MI 49085-9137 | 2006-09-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134758949 | Ahmed Elshareif | Student in an Organized Health Care Education/Training Program | Lakeland Health, 1234 Napier Avenue, Saint Joseph, MI 49085 | 2020-04-03 |
| 1033747225 | Ezra Fox | Student in an Organized Health Care Education/Training Program | Lakeland Health- Gme, 1234 Napier Avenue, St. Joseph, MI 49085 | 2020-04-01 |
| 1679033930 | Asad Butt | Student in an Organized Health Care Education/Training Program | Lakeland Health-gme, 1234 Napier Avenue, Saint Joseph, MI 49085 | 2019-03-22 |
| 1184194714 | Benjamin Phillip Knuth | Physical Therapist | 3950 Hollywood Road, Suite 140, Saint Joseph, MI 49085 | 2018-11-27 |
| 1336624279 | Brandi Chatot | Counselor | 1101 Broad Street #8, Saint Joseph, MI 49085 | 2018-09-26 |
| 1396239562 | Lakeland Medical Practices | Family Medicine | 2500 Niles Ave., Suite 1, St. Joseph, MI 49085 | 2018-06-20 |
| 1760976518 | Premier Health Associates, Inc. | Home Health | 1111 Main Sr, St Joseph, MI 49085 | 2018-06-15 |
| 1053817783 | Chantell Strong | Student in an Organized Health Care Education/Training Program | Lakeland Health - Gme, 1234 Napier Avenue, Saint Joseph, MI 49085 | 2018-04-02 |
| 1386144053 | Anjana Gupta, Dds, Pllc | Dentist | 2800 Niles Road, Saint Joseph, MI 49085 | 2018-02-19 |
| 1356858997 | Hope Reborn Counseling, Pllc | Counselor | 2816 Willa Dr, Saint Joseph, MI 49085 | 2018-01-04 |
| Find all providers in zip 49085 | ||||
| Taxonomy Code | 208200000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Plastic Surgery |
| A plastic surgeon deals with the repair, reconstruction or replacement of physical defects of form or function involving the skin, musculoskeletal system, craniomaxillofacial structures, hand, extremities, breast and trunk and external genitalia or cosmetic enhancement of these areas of the body. Cosmetic surgery is an essential component of plastic surgery. The plastic surgeon uses cosmetic surgical principles to both improve overall appearance and to optimize the outcome of reconstructive procedures. The surgeon uses aesthetic surgical principles not only to improve undesirable qualities of normal structures but in all reconstructive procedures as well. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Plastic Surgery, 2007. http://www.abplsurg.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Plastic Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063771087 | Nicole Alexis Phillips | Plastic Surgery | 3901 Stonegate Park Ste 300, Saint Joseph, MI 49085-9136 | 2012-05-10 |
| 1558570580 | Karen Lynne Powers | Plastic Surgery | 3901 Stonegate Park, Suite 300, Saint Joseph, MI 49085-9137 | 2007-05-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285100719 | Nuvantage Wound Care Solutions Pllc | Plastic Surgery | 21717 Rose Hollow Dr, Southfield, MI 48075-5508 | 2018-10-23 |
| 1134614886 | Landmark Surgery Center | Plastic Surgery | 26850 Providence Pkwy Ste 125b, Novi, MI 48374-1253 | 2018-06-26 |
| 1194102467 | Matthew Kenneth Shaheen | Plastic Surgery | 28050 Grand River Ave Ste 518, Farmington Hills, MI 48336-5919 | 2015-05-06 |
| 1649675174 | Executive Plastic Surgery, Pllc | Plastic Surgery | 26850 Providence Pkwy Ste 125, Novi, MI 48374-1253 | 2014-10-27 |
| 1891109971 | John Philip Kelpin Jr. | Plastic Surgery | 221 Michigan St Ne # Mc106, Suite 200a, Grand Rapids, MI 49503-2543 | 2014-06-17 |
| 1891108759 | Jeffrey Thomas Desano II | Plastic Surgery | 31100 Telegraph Rd Ste 280, Bingham Farms, MI 48025 | 2014-06-09 |
| 1518306315 | Sarah M Elswick | Plastic Surgery | 201 W Big Beaver Rd Ste 1130, Troy, MI 48084-5298 | 2013-06-14 |
| 1730527326 | Advanced Plastic Surgery, PC | Plastic Surgery | 4551 Cascade Rd Se, Suite D, Grand Rapids, MI 49546-8372 | 2013-06-05 |
| 1396095568 | Cascade Plastic Surgery Plc | Plastic Surgery | 1514 Fourth St, Jackson, MI 49203-4032 | 2012-09-14 |
| 1013262476 | Ahmet R Karaca Md PC | Plastic Surgery | 101 Townsend St, Birmingham, MI 48009-6001 | 2012-07-20 |
| Find all providers with the same taxonomy | ||||
| City | SAINT JOSEPH |
| Zip Code | 49085 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.