Family Healthcare Ninety Six, A Division Of Self Medical Group | |
103 Little Mountain Rd Ninety Six SC 29666-9252 | |
(864) 543-3515 | |
Not Available |
Full Name | Family Healthcare Ninety Six, A Division Of Self Medical Group |
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Speciality | Family Medicine |
Location | 103 Little Mountain Rd, Ninety Six, South Carolina |
Authorized Official Name and Position | Matthew T Logan (PRESIDENT AND CEO) |
Authorized Official Contact | 8647254253 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Family Healthcare Ninety Six, A Division Of Self Medical Group 103 Little Mountain Rd Ninety Six SC 29666-9252 Ph: (864) 543-3515 | Family Healthcare Ninety Six, A Division Of Self Medical Group 103 Little Mountain Rd Ninety Six SC 29666-9252 Ph: (864) 543-3515 |
NPI Number | 1609262807 |
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Provider Enumeration Date | 04/14/2015 |
Last Update Date | 12/14/2021 |
Identifier | Type | State | Issuer |
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1609262807 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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207Q00000X | Family Medicine | (* (Not Available)) | Primary |