SELF MEDICAL GROUP NPI 1205475688

NPI Information

  • NPI: 1205475688
  • Provider Name: SELF MEDICAL GROUP
  • Classification: Internal Medicine - 207RN0300X
  • Specialization: Nephrology
  • Entity Type: Organization
  • Other Name: NEPHROLOGY SERVICES OF SELF MEDICAL GROUP
  • CLIA Number: 42D2230031
  • Address: 1123 SPRING ST
    GREENWOOD, SC
    ZIP 29646
  • Phone: (864) 450-9036

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NPI Details

SELF MEDICAL GROUP is a nephrology internal medicine in Greenwood, SC. The provider is an internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation. SELF MEDICAL GROUP NPI is 1205475688. The provider is registered as an organization entity type and is a single specialty group.
The provider Other Name Is Nephrology Services Of Self Medical Group.

The provider's business location address is:

1123 SPRING ST
GREENWOOD, SC
ZIP 29646-833
Phone: (864) 450-9036
Fax: (864) 450-9038

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 42D2230031 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 1/2/2020 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
1207RN0300XInternal MedicineNephrologyYes

What is NPI?

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This page was last updated on: 11/21/2025

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