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Organization
SELF MEDICAL GROUP
Active
Organization
SELF MEDICAL GROUP
Active
Other names
South Carolina Spine Associates, A Division of SMG
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MATTHEW T LOGAN MD (PRESIDENT AND CEO)
(864) 725-4253
Entity
Organization
Contact information
Practice address
115 ACADEMY AVENUE, UNIT A, GREENWOOD, SC 29646
(864) 725-7272
(864) 725-5764
Mailing address
115 ACADEMY AVENUE, UNIT A, GREENWOOD, SC 29646
(864) 725-7272
(864) 725-5764
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
NULL
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
—
363A00000X
Physician Assistant
—
NULL
363A00000X
Physician Assistant
—
—
Other
Enumeration date
03/10/2010
Last updated
12/14/2021
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