Self Medical Group

NPI #1477880003 in Newberry, South Carolina

Provider Information

NPI Number: 1477880003
Entity Type: Organization
Organization Name: Self Medical Group
Primary Specialty: Family Medicine
Enumeration Date: Nov 3, 2009
Last Updated: Dec 14, 2021

Practice Location

Address: 2605 KINARD STREET
Address 2: SUITE 200
City: Newberry
State: South Carolina
ZIP Code: 29108-2967
Phone: (803) 405-1900

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
Family Medicine	207Q00000X	Primary
Clinic/Center - Rural Health — Rural Health	261QR1300X

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