Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Logan Harrison Robertson

Individual provider Physician Assistant · NPI 1093343402

Logan Harrison Robertson is a Physician Assistant in Hagerstown, Maryland. Qualified in 2021, 5 years ago. Practices with Medical Practices of Antietam, LLC, a 231-clinician group, works from 2 locations, accepts Medicare assignment and offers telehealth. Licensed in Maryland.

Years since qualifying
5
Licensed in
MD
In the registry since
2020
Specialties on file
3

Practice location Address checks out

11110 Medical Campus Rd Ste 200
Hagerstown, MD 21742-6797
Phone: (301) 714-4400
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 1583 Luther Michael Rd, Berkeley Springs, WV 25411-7263 — (304) 839-4215

Specialties & licences

Medical Physician Assistant (primary) Taxonomy 363AM0700X · Licence C0008038 (MD)
Physician Assistant Taxonomy 363A00000X · Licence C08038 (MD)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1093343402
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedMarch 31, 2020
Last updated in NPPESNovember 10, 2021
Certification dateNovember 10, 2021
Mailing address11110 Medical Campus Rd Ste 200, Hagerstown, MD 21742-6797

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Group practice Medical Practices Of Antietam, Llc — 231 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations3 on file with Medicare

Other providers in Hagerstown