Provider Demographics
NPI:1740209592
Name:LOGAN, CATHERINE ANNE (MD)
Entity Type:Individual
Prefix:MRS
First Name:CATHERINE
Middle Name:ANNE
Last Name:LOGAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4500 E 9TH AVE STE 420
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80220-3931
Mailing Address - Country:US
Mailing Address - Phone:720-726-7995
Mailing Address - Fax:
Practice Address - Street 1:4500 E 9TH AVE STE 420
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80220-3931
Practice Address - Country:US
Practice Address - Phone:720-726-7995
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-19
Last Update Date:2023-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA251577207X00000X
MA17313225100000X
CODR.0058454207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist