Organization
SELF MEDICAL GROUP
Active
Other names
Advanced Cardiothoracic Surgery, 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
1506 SPRING ST, GREENWOOD, SC 29646-4071
(864) 725-7900
(864) 725-7910
Mailing address
105 VINECREST CT # 500, GREENWOOD, SC 29646-8031
(864) 725-7900
(864) 725-7910
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
—
—
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
—
—
Other
Enumeration date
05/18/2010
Last updated
05/31/2024
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