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SELF MEDICAL GROUP NPI 1871809855


NPI Information

NPI: 1871809855
Provider Name: SELF MEDICAL GROUP

Other Name: UROLOGICAL SERVICES OF SELF MEDICAL GROUP

Classification: Urology - 208800000X
Entity Type: Organization

CLIA Number: 42D2298188

Address:
109 LINER DR
GREENWOOD, SC
ZIP 29646
Phone: (864) 227-6401
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SELF MEDICAL GROUP is an urology in Greenwood, SC. The provider is a urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures. SELF MEDICAL GROUP NPI is 1871809855. The provider is registered as an organization entity type and is a single specialty group.
The provider Other Name Is Urological Services Of Self Medical Group.

The provider's business location address is:

109 LINER DR
GREENWOOD, SC
ZIP 29646-311
Phone: (864) 227-6401
Fax: (864) 941-4995

The provider's authorized official is Matthew T Logan .
The authorized official title is President And Ceo and has the following contact phone number (864) 725-4253.

The CLIA number assigned to this NPI record is 42D2298188 - physician office with a certificate type of Certificate of Accreditation.

The enumeration date for this NPI number is 8/27/2010 and was last updated on 12/14/2021.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1208800000XUrologyYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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