Self Medical Group

NPI #1629382056 in Mccormick, South Carolina

Provider Information

NPI Number: 1629382056
Entity Type: Organization
Organization Name: Self Medical Group
Primary Specialty: Family Medicine
Enumeration Date: Jul 27, 2010
Last Updated: Dec 14, 2021

Practice Location

Address: 207 HOLIDAY ROAD
City: Mccormick
State: South Carolina
ZIP Code: 29835-3430
Phone: (864) 391-5011

Authorized Official

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

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Family Medicine	207Q00000X	Primary

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