Organization
SELF MEDICAL GROUP
Active
Other names
Advanced Surgical 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
160 ACADEMY AVENUE, GREENWOOD, SC 29646-3808
(864) 223-8090
(864) 223-4026
Mailing address
160 ACADEMY AVENUE, GREENWOOD, SC 29646-3808
(864) 223-8090
(864) 223-4026
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
—
Other
Enumeration date
09/22/2009
Last updated
12/14/2021
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