LOGAN DISHAWN MATHUS PTT NPI 1952146987

NPI Information

  • NPI: 1952146987
  • Provider Name: LOGAN DISHAWN MATHUS, PTT
  • Classification: Military Health Care Provider - 171000000X
  • Entity Type: Individual
  • Address: 2480 LLEWELLYN AVE
    FORT MEADE, MD
    ZIP 20755
  • Phone: (301) 677-8796

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NPI Details

Logan Dishawn Mathus, PTT is a military health care provider in Fort Meade, MD. The provider is active duty military health care providers not otherwise classified who need to be separately identified for operational, clinical, or administrative processes. Logan Dishawn Mathus, PTT NPI is 1952146987. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

2480 LLEWELLYN AVE
FORT MEADE, MD
ZIP 20755-081
Phone: (301) 677-8796

The enumeration date for this NPI number is 7/1/2024 and was last updated on 7/1/2024.

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
1171000000XMilitary Health Care ProviderYes

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

NPI Synchronization or Removal

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