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Organization
SELF MEDICAL GROUP
Active
Organization
SELF MEDICAL GROUP
Active
Other names
Ready for Surgery Clinic of Self Medical Group
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
105 VINECREST CT # 510, GREENWOOD, SC 29646-8031
(864) 725-4016
(864) 725-5839
Mailing address
105 VINECREST CT # 510, GREENWOOD, SC 29646-8031
(864) 725-4016
(864) 725-5839
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
05/29/2019
Last updated
12/14/2021
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