OrganizationActive
Self Medical Group
NPI 1104137892 · Internal Medicine Physician · Laurens, SC
Provider details
- NPI number
- 1104137892
- Entity type
- Organization
- Primary specialty
- Internal Medicine PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Matthew Logan, President and Chief Executive Offic(864) 725-4253
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
Detailed profile(83/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
15 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
22580 Highway 76 E
Suite 200
Laurens, SC 29360-8439
Phone: (864) 833-0055
Fax: (864) 833-4008
Street-level locationGet directions
Mailing address
22580 Highway 76 E
Laurens, SC 29360-8439
Other names (DBA / former)
- Other name
- Internal Medical Laurens a Division of Self Medical Group
- Other name
- Internal Medical Laurens a Division of Self Medical Group
Registry dates
- Enumerated
- 2010-06-28
- Last updated
- 2021-12-14
- Certified
- 2021-12-14
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.