# SELF REGIONAL HEALTHCARE

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Internal Medicine of Greenwood
- **Organization subpart:** No

## Provider details

- **NPI number:** 1053103572
- **Authorized official:** MATTHEW TOLBERT LOGAN MD (PRESIDENT & CEO)
- **Authorized official phone:** (864) 725-4780

## Contact information

- **Practice address:** 115 OVERLAND DR, GREENWOOD, SC 29646-4053
- **Practice address phone:** (864) 227-6641
- **Practice address fax:** (864) 227-3953
- **Mailing address:** 1325 SPRING ST, GREENWOOD, SC 29646-3860
- **Mailing address phone:** (864) 725-4673
- **Mailing address fax:** (864) 725-7424

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | — | NULL | Yes |
| 207R00000X | Internal Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 05/20/2025
- **Last updated:** 05/20/2025