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Organization
SELF MEDICAL GROUP
Active
Organization
SELF MEDICAL GROUP
Active
Other names
Nephrology Services of Self Medical Group
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MATTHEW T LOGAN (PRESIDENT AND CEO)
(864) 725-4253
Entity
Organization
Contact information
Practice address
1123 SPRING ST, GREENWOOD, SC 29646-3833
(864) 450-9036
(864) 450-9038
Mailing address
1123 SPRING ST, GREENWOOD, SC 29646-3833
(864) 450-9036
(864) 450-9038
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
—
—
Other
Enumeration date
01/02/2020
Last updated
12/14/2021
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