Organization
SELF MEDICAL GROUP
Active
Parent organization
SELF MEDICAL GROUP
Other names
Internal Medicine of the Piedmont, A Division of Self Medical Group
Organization subpart
Yes
Provider details
NPI number
Legal business name
SELF MEDICAL GROUP
Authorized official
DR. MATTHEW T LOGAN MD (PRESIDENT AND CHIEF EXECUTIVE OFFIC)
(864) 725-4253
Entity
Organization
Contact information
Practice address
104 LINER DRIVE, GREENWOOD, SC 29646
(864) 227-1115
(864) 227-2046
Mailing address
104 LINER DRIVE, GREENWOOD, SC 29646
(864) 227-1115
(864) 227-2046
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
363L00000X
Nurse Practitioner
—
—
Other
Enumeration date
01/24/2011
Last updated
12/14/2021
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