| NPI | 1720475221 |
|---|---|
| Other Name | PEDIATRIC ASSOCIATES GREENWOOD, A DIVISION OF SELF MEDICAL GROUP |
| Entity Type | Organization |
| Authorized Contact | MATTHEW T LOGAN President And CEO 864-725-4253 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208000000X Pediatrics |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 363LF0000X Nurse Practitioner, Family | |
| 363LP0200X Nurse Practitioner, Pediatrics | |
| Enumeration Date | 2015-04-22 |
| Last Update Date | 2021-12-14 |