Organization
SELF MEDICAL GROUP
Active
Other names
Anesthesiology Services 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
1325 SPRING ST, GREENWOOD, SC 29646-3860
(864) 725-4111
(864) 725-7498
Mailing address
1325 SPRING ST, GREENWOOD, SC 29646-3860
(864) 725-4111
(864) 725-7498
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
Other
Enumeration date
07/08/2019
Last updated
12/14/2021
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