Graduated: 2006
NPI: 1437380888
Practice Locations (2)
SELF MEDICAL GROUP
1123 SPRING ST
GREENWOOD, SC 296463833
8644509036
PUBLIC HOSPITAL DIST NO 1 SKAGIT
1400 E KINCAID ST
MOUNT VERNON, WA 982744127
3604282500
Source: CMS National Downloadable File, September 2026.