Self Medical Group
NPI #1609262807 in Ninety Six, South Carolina
Provider Information
- NPI Number
- 1609262807
- Entity Type
- Organization
- Organization Name
- Self Medical Group
- Primary Specialty
- Family Medicine
- Enumeration Date
- Apr 14, 2015
- Last Updated
- Dec 14, 2021
Practice Location
- Address
- 103 LITTLE MOUNTAIN RD
- City
- Ninety Six
- State
- South Carolina
- ZIP Code
- 29666-9252
- Phone
- (864) 543-3515
Authorized Official
- Name
- DR. MATTHEW T LOGAN
- Title
- PRESIDENT AND CEO
- Phone
- (864) 725-4253
Specialties & Taxonomy Codes
| Specialty |
|---|
| Family Medicine |
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