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SELF MEDICAL GROUP NPI 1942528161


NPI Information

NPI: 1942528161
Provider Name: SELF MEDICAL GROUP

Other Name: FAMILY HEALTHCARE WARE SHOALS A DIVISION OF SELF MEDICAL GROUP

Classification: Family Medicine - 207Q00000X
Entity Type: Organization

CLIA Number: 42D0918491

Address:
167 GREENWOOD AVE S
WARE SHOALS, SC
ZIP 29692
Phone: (864) 456-3447
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SELF MEDICAL GROUP is a family medicine in Ware Shoals, SC. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. SELF MEDICAL GROUP NPI is 1942528161. The provider is registered as an organization entity type and is a single specialty group.
The provider Other Name Is Family Healthcare Ware Shoals A Division Of Self Medical Group.

The provider's business location address is:

167 GREENWOOD AVE S
WARE SHOALS, SC
ZIP 29692
Phone: (864) 456-3447
Fax: (864) 725-4979

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

The CLIA number assigned to this NPI record is 42D0918491 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 5/12/2010 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
1207Q00000XFamily MedicineYes

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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