# SELF MEDICAL GROUP

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Full Circle Care
- **Organization subpart:** No

## Provider details

- **NPI number:** 1457943185
- **Authorized official:** DR. MATTHEW T LOGAN MD (PRESIDENT AND CEO)
- **Authorized official phone:** (864) 725-4253

## Contact information

- **Practice address:** 1132 SPRING ST, GREENWOOD, SC 29646-3859
- **Practice address phone:** (864) 725-1680
- **Practice address fax:** (864) 725-1683
- **Mailing address:** 1132 SPRING ST, GREENWOOD, SC 29646-3859
- **Mailing address phone:** (864) 725-1680
- **Mailing address fax:** (864) 725-1683

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | — |
| 207Q00000X | Family Medicine Physician | — | — | — |
| 207R00000X | Internal Medicine Physician | — | NULL | Yes |
| 207R00000X | Internal Medicine Physician | — | — | Yes |
| 207RC0000X | Cardiovascular Disease Physician | — | NULL | — |
| 207RC0000X | Cardiovascular Disease Physician | — | — | — |

## Other

- **Enumeration date:** 02/04/2021
- **Last updated:** 12/14/2021