| NPI | 1124488895 |
|---|---|
| Other Name | ADVANCED VASCULAR ASSOCIATES A DIVISION OF SELF MEDICAL GROUP |
| Entity Type | Organization |
| Authorized Contact | MATTHEW T LOGAN President And CFO 864-725-4253 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2086S0129X |
| Additional Taxonomies | 208600000X Surgery |
| Enumeration Date | 2016-02-24 |
| Last Update Date | 2021-12-14 |