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Organization
SELF MEDICAL GROUP
Active
Organization
SELF MEDICAL GROUP
Active
Other names
Advanced Obstetrics and Gynecology
Organization subpart
No
Provider details
NPI number
Authorized official
MATTHEW T LOGAN (PRESIDENT AND CEO)
(864) 725-4253
Entity
Organization
Contact information
Practice address
1029A EDGEFIELD ST, GREENWOOD, SC 29646-3205
(864) 388-2122
(864) 388-7948
Mailing address
1029A EDGEFIELD ST, GREENWOOD, SC 29646-3205
(864) 388-2122
(864) 388-7948
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
—
—
Other
Enumeration date
11/03/2022
Last updated
11/03/2022
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