Organization

Self Medical Group

May also be knows as Lifestyle Clinic Of Self Medical Group

Family Medicine Physician in Greenwood, SC(View on Map)

Legal Business Name

Self Medical Group

Also Known As

Lifestyle Clinic Of Self Medical Group

NPI Number

1013570910

NPI Type

Organization

Enumeration Date

04/16/2019

Specialties

(Taxonomies)

Code

207Q00000X

Primary Taxonomy

Yes

Contact
Information

Purpose

Mailing
Location

Address

410 EPTING AVE
410 EPTING AVE

City

Greenwood
Greenwood

State

SC
SC

Postal Code

29646-4040
29646-4040

Country

US
US

Telephone Number

(864) 725-7880
(864) 725-7880

Authorized Official

Name

Dr. Matthew Logan

Title or Position

PRESIDENT AND CEO

Telephone Number

(864) 725-4253

Provider data last refreshed from NPPES NPI registry on 11/19/2024

Data last updated by provider on 12/14/2021

Provider Address

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Organization

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Organization

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Organization

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Organization

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Organization

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