LOGAN INTERNAL MEDICINE GROUP NPI 1730117896

NPI Information

  • NPI: 1730117896
  • Provider Name: LOGAN INTERNAL MEDICINE GROUP
  • Classification: Internal Medicine - 207R00000X
  • Entity Type: Organization
  • Doing Business As: LOGAN INTERNAL MEDICINE GROUP
  • Address: 77 HOSPITAL DRIVE
    SUITE 101
    LOGAN, WV
    ZIP 25601
  • Phone: (304) 831-0450

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NPI Details

LOGAN INTERNAL MEDICINE GROUP is an internal medicine in Logan, WV. The provider is a physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. LOGAN INTERNAL MEDICINE GROUP NPI is 1730117896. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Logan Internal Medicine Group.

The provider's business location address is:

77 HOSPITAL DRIVE
SUITE 101
LOGAN, WV
ZIP 25601-451
Phone: (304) 831-0450
Fax: (304) 831-0452

The provider's authorized official is Fernando Luis Gonzalez-ramos .
The authorized official title is Ceo and has the following contact phone number (304) 831-0450.

The enumeration date for this NPI number is 6/29/2006 and was last updated on 2/10/2011.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207R00000XInternal MedicineYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
13810011047MEDICAIDWEST VIRGINIA
2001860338OTHERBCBS OF MICHIGAN
39362661MEDICARE PINWEST VIRGINIA
4611399500OTHERBLACK LUNG
5H81528MEDICARE UPINWEST VIRGINIA
6001860338OTHERMOUNTAIN STATE BCBS
7DF2728OTHERWEST VIRGINIARR MEDICARE
8438170OTHERADVANTRA FREEDOM
9438170OTHERCOVENTRY HEALTH

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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