Organization
SELF MEDICAL GROUP
Active
Other names
Urological Services of Self Medical Group
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MATTHEW T LOGAN MD (PRESIDENT AND CEO)
(864) 725-4253
Entity
Organization
Contact information
Practice address
109 LINER DR, GREENWOOD, SC 29646-2311
(864) 227-6401
(864) 941-4995
Mailing address
109 LINER DR, GREENWOOD, SC 29646-2311
(864) 227-6401
(864) 941-4995
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
—
—
Other
Enumeration date
08/27/2010
Last updated
12/14/2021
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