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General NPI Number Information
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NPI Number | 1568485134
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Entity Type | Individual
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Provider Name | ARIKE LOGAN M.D.
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Gender | Female
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Dates
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Enumeration Date | 07/25/2006
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Last Update Date | 10/20/2010
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Provider Practice Location Address
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Address Line | 1395 S MARIETTA PKWY SE BLDG 100 STE 101
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City | MARIETTA
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State | GA
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Zip | 30067-4440
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Country | US
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Telephone | 770-425-8700
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Fax | 770-425-8740
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Provider Business Mailing Address
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Address Line | 5270 PEACHTREE PKWY SUITE 116
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City | NORCROSS
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State | GA
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Zip | 30092-6510
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Country | US
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Telephone | 770-446-6789
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Fax | 770-446-7879
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 031466
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License Number State | GA
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