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Contact Information

SELF MEDICAL GROUP
104 LINER DRIVE
GREENWOOD, SC29646
 Phone: 864-227-1115
 Fax: 864-227-2046
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Internal Medicine

207R00000X 11 Physician/Internal Medicine
 

Nurse Practitioner

363L00000X 50 Nurse Practitioner
Indicates primary specialty

NPI Profile & details for SELF MEDICAL GROUP

NPI Number 1588969448
LBN Legal business name SELF MEDICAL GROUP
Authorized official MATTHEW LOGAN - (PRESIDENT AND CHIEF EXECUTIVE OFFIC)
Entity Organization
Organization subpart 1 Yes
Enumeration date 01/24/2011
Last updated 12/14/2021 - About 4 years ago
Identifiers n/a
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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