THEODORE F LOGAN

INDIANAPOLIS, IN
NPI1568428498
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy207RH0003X Internal Medicine, Hematology & Oncology
(Licence: IN  01051224)
Enumeration Date2006-04-20
Last Update Date2014-02-10
Business Address
-- THEODORE F LOGAN M.D.
535 BARNHILL DR RT 473
INDIANAPOLIS, IN 46202-5112
Phone number: 317-278-7576
Mailing Address
-- THEODORE F LOGAN M.D.
250 N SHADELAND AVE STE 130 PROVIDER ENROLLMENT
INDIANAPOLIS, IN 46219-4959
Phone number:
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