Provider Demographics
NPI:1215631577
Name:YUSUF, LOGAN CERWIN (DO)
Entity type:Individual
Prefix:
First Name:LOGAN
Middle Name:CERWIN
Last Name:YUSUF
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:LOGAN
Other - Middle Name:ROBIN
Other - Last Name:CERWIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:2555 UNIVERSITY DR
Mailing Address - Street 2:
Mailing Address - City:FAIRBORN
Mailing Address - State:OH
Mailing Address - Zip Code:45324-6255
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2555 UNIVERSITY DR
Practice Address - Street 2:
Practice Address - City:FAIRBORN
Practice Address - State:OH
Practice Address - Zip Code:45324-6255
Practice Address - Country:US
Practice Address - Phone:937-775-7792
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-29
Last Update Date:2023-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program