Self Medical Group

NPI #1104137892 in Laurens, South Carolina

Provider Information

NPI Number: 1104137892
Entity Type: Organization
Organization Name: Self Medical Group
Primary Specialty: Internal Medicine
Enumeration Date: Jun 28, 2010
Last Updated: Dec 14, 2021

Practice Location

Address: 22580 HIGHWAY 76 E
Address 2: SUITE 200
City: Laurens
State: South Carolina
ZIP Code: 29360-8439
Phone: (864) 833-0055

Authorized Official

Name: DR. MATTHEW T LOGAN, MD
Title: PRESIDENT AND CHIEF EXECUTIVE OFFIC
Phone: (864) 725-4253

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Internal Medicine	207R00000X	Primary

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