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Organization
SELF MEDICAL GROUP
Active
Organization
SELF MEDICAL GROUP
Active
Other names
Advanced Oncology Hematology, A Division of Self Medical Group
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MATTHEW T LOGAN (PRESIDENT AND CHIEF EXECUTIVE OFFIC)
(864) 725-4253
Entity
Organization
Contact information
Practice address
1325 SPRING STREET, GREENWOOD, SC 29646-3860
(864) 725-7100
(864) 725-7101
Mailing address
1325 SPRING STREET, GREENWOOD, SC 29646-3860
(864) 725-7100
(864) 725-7101
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
—
—
2085R0001X
Radiation Oncology Physician
—
—
Other
Enumeration date
05/18/2010
Last updated
12/14/2021
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