Organization
SELF MEDICAL GROUP
Active
Other names
Orthopaedic Associates of the Lakelands, A Division of Self Medical
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MATTHEW T LOGAN MD (PRESIDENT)
(864) 725-4253
Entity
Organization
Contact information
Practice address
102 GREGOR MENDEL CIR, GREENWOOD, SC 29646-2315
(864) 229-2663
(864) 223-0539
Mailing address
102 GREGOR MENDEL CIR, GREENWOOD, SC 29646-2315
(864) 229-2663
(864) 223-0536
Taxonomy
Speciality
Code
Description
License number
State
207QS0010X
Sports Medicine (Family Medicine) Physician
—
—
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
207XS0106X
Orthopaedic Hand Surgery Physician
—
—
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
Other
Enumeration date
10/13/2015
Last updated
05/27/2026
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