Organization
SELF MEDICAL GROUP
Active
Organization
SELF MEDICAL GROUP
Active
Other names
Advanced Cardiology Associates, A Division of Self Medical Group
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MATTHEW T LOGAN MD (PRESIDENT AND CHIEF EXECUTIVE OFFIC)
(864) 725-4253
Entity
Organization
Contact information
Practice address
421 EPTING AVE, GREENWOOD, SC 29646-4041
(864) 227-6818
Mailing address
421 EPTING AVE, GREENWOOD, SC 29646-4041
(864) 227-6818
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
—
—
207RC0001X
Clinical Cardiac Electrophysiology Physician
—
—
207RI0011X
Interventional Cardiology Physician
—
—
Other
Enumeration date
10/06/2010
Last updated
12/14/2021
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