Healthcare Provider Details

I. General information

NPI: 1538689807
Provider Name (Legal Business Name): LOGAN WELLS HUFF MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/27/2017
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1801 SUNSET DRIVE ORTHOPAEDIC SURGERY CLINIC
COLUMBIA SC
29203
US

IV. Provider business mailing address

1801 SUNSET DRIVE ORTHOPAEDIC SURGERY CLINIC
COLUMBIA SC
29203
US

V. Phone/Fax

Practice location:
  • Phone: 803-434-4166
  • Fax: 803-434-4183
Mailing address:
  • Phone: 803-434-4166
  • Fax: 803-434-4183

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberLL41064
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: