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NPI Code Detail

MEDICARE: STEPHAN LOGINSKY

MEDICARE: STEPHAN LOGINSKY
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12085R0202XDiagnostic Radiology Physician40903KY
22085R0202XDiagnostic Radiology Physician4301040405MI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2300F362480OTHERMIBCBSM
3000000541332OTHERKYBCBS PROVIDER NUMBER
4MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1710947072
Entity Type Code : Individual
Provider Name (Legal Business Name) : STEPHAN LOGINSKY
Provider Business Mailing Address
First Line : 26901 BEAUMONT BLVD # 3D
Second Line :
City : SOUTHFIELD
State : MI
Zip : 48033-3849
Country : US
Telephone Number : 947-522-1952
Fax Number : 947-522-0307
Provider Business Practice Location Address
First Line : 44201 DEQUINDRE RD
Second Line :
City : TROY
State : MI
Zip : 48085-1117
Country : US
Telephone Number : 248-964-5190
Fax Number : 248-964-5199
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/23/2006
Last Update Date : 06/01/2026

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Directions to “ STEPHAN LOGINSKY ” Practice Location

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