SELF MEDICAL GROUP NPI 1033832530

NPI Information

NPI: 1033832530
Provider Name: SELF MEDICAL GROUP

Other Name: LAKELANDS PLASTIC SURGERY

Classification: Surgery - 2086S0122X
Entity Type: Organization

Specialization: Plastic and Reconstructive Surgery

Address:
305 W ALEXANDER AVE # A
GREENWOOD, SC
ZIP 29646
Phone: (864) 223-0505
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SELF MEDICAL GROUP is a plastic and reconstructive surgery surgery in Greenwood, SC. The provider is a surgeon who specializes in plastic and reconstructive surgery. SELF MEDICAL GROUP NPI is 1033832530. The provider is registered as an organization entity type and is a single specialty group.
The provider Other Name Is Lakelands Plastic Surgery.

The provider's business location address is:

305 W ALEXANDER AVE # A
GREENWOOD, SC
ZIP 29646-009
Phone: (864) 223-0505
Fax: (864) 223-7075

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 enumeration date for this NPI number is 9/21/2022 and was last updated on 11/7/2022.

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
1	2086S0122X	Surgery	Plastic and Reconstructive Surgery			Yes

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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