Organization
SELF MEDICAL GROUP
Active
Other names
Accountable Care
Organization subpart
No
Provider details
NPI number
Authorized official
MATTHEW T LOGAN MD (PRESIDENT AND CEO)
(864) 725-4253
Entity
Organization
Contact information
Practice address
102 KATIE CT, GREENWOOD, SC 29646-4068
(864) 725-7770
(864) 725-7774
Mailing address
102 KATIE CT, GREENWOOD, SC 29646-4068
(864) 725-7770
(864) 725-7774
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
363L00000X
Nurse Practitioner
Primary
—
—
Other
Enumeration date
02/24/2022
Last updated
02/06/2026
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