Michael J. Logan MD, SC

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

License

16418-20 Issued in WI

Legal business name

MICHAEL J. LOGAN MD, SC

Practice address

16535 W Bluemound Rd Ste 200
Brookfield, WI 53005-5906

Phone

(262) 789-0909

Fax

(262) 821-6180

NPI assigned

Nov 22, 2010

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Michael Jeffrey Logan, M.D.

Title

Owner/President

Phone

(262) 786-1710

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1290384000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1290384000000",
    "number": "1093017196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15065 WESTOVER RD",
            "city": "ELM GROVE",
            "state": "WI",
            "postal_code": "531221541",
            "telephone_number": "262-786-1710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16535 W BLUEMOUND RD STE 200",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "530055906",
            "telephone_number": "262-789-0909",
            "fax_number": "262-821-6180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHAEL J. LOGAN MD, SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-22",
        "last_updated": "2010-11-22",
        "status": "A",
        "authorized_official_last_name": "LOGAN",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "JEFFREY",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "262-786-1710",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "WI",
            "license": "16418-20",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sarah Meuler, PT
• Courtney Meyerhofer, BCBA
• Rachel Colleen Meyers, FNP
• Stacy Ann Miceli
• Michael Chiropractic Center SC
• Mark A Michael, DC
• Anna M Michalkiewicz, RN
• Sophie Michalski
• Angela Irene Michor, NP, MSN
• Robert William Miclot Jr., DC

• Mental Health Clinic/Center (Including Community Mental Health Center) in Brookfield, WI
• Providers in Brookfield, WI by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.