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Contact Information

SELF MEDICAL GROUP
115 ACADEMY AVE
GREENWOOD, SC29646-3869
 Phone: 864-725-7272
 Fax: 864-725-5799
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Neurological Surgery

207T00000X 02 Physician/General Surgery
 

Durable Medical Equipment & Medical Supplies

332B00000X 54 Other Medical Supply Company
 

Nurse Practitioner

363L00000X 50 Nurse Practitioner
 

Physical Medicine & Rehabilitation

208100000X 25 Physician/Physical Medicine and Rehabilitation
 

Surgical

363AS0400X 97 Physician Assistant
Indicates primary specialty

NPI Profile & details for SELF MEDICAL GROUP · (Female)

NPI # 1902277270
Status Active
Credentials
Entity Individual
Enumeration date 10/13/2015
Last updated 05/15/2026 - About 3 weeks ago
Sole proprietor 1 Not specified
Identifiers
  • SC Medicaid DE3708
  • SC Medicaid GP7015
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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