Provider Demographics
NPI:1780413161
Name:LOGAN B. HANERT DO, PC
Entity type:Organization
Organization Name:LOGAN B. HANERT DO, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHIATRIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LOGAN
Authorized Official - Middle Name:BRYCE
Authorized Official - Last Name:HANERT
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:906-287-0828
Mailing Address - Street 1:640 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:NORWAY
Mailing Address - State:MI
Mailing Address - Zip Code:49870-1246
Mailing Address - Country:US
Mailing Address - Phone:906-779-7001
Mailing Address - Fax:
Practice Address - Street 1:640 MAIN ST
Practice Address - Street 2:
Practice Address - City:NORWAY
Practice Address - State:MI
Practice Address - Zip Code:49870-1246
Practice Address - Country:US
Practice Address - Phone:906-779-7001
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-01
Last Update Date:2024-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty