Organization
SELF MEDICAL GROUP
Active
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
115 ACADEMY AVE, GREENWOOD, SC 29646-3869
(864) 725-7272
(864) 725-5799
Mailing address
115 ACADEMY AVE, GREENWOOD, SC 29646-3869
(864) 725-7272
(864) 725-5799
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
—
—
208100000X
Physical Medicine & Rehabilitation Physician
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
363AS0400X
Surgical Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
DE3708
—
SC
05
—
GP7015
—
SC
Enumeration date
10/13/2015
Last updated
05/15/2026
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