| Midlands Neurology & Pain Assoc, P.a | |
|
2601 Millwood Ave Columbia SC 29205-1218 | |
| (803) 788-0038 | |
| Not Available |
| Full Name | Midlands Neurology & Pain Assoc, P.a |
|---|---|
| Speciality | Psychiatry & Neurology - Addiction Medicine |
| Location | 2601 Millwood Ave, Columbia, South Carolina |
| Authorized Official Name and Position | Eleanya Ogburu-ogbonnaya (PRESIDENT CEO) |
| Authorized Official Contact | 8037880038 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Midlands Neurology & Pain Assoc, P.a Po Box 209 State Park SC 29147-0209 Ph: () - | Midlands Neurology & Pain Assoc, P.a 2601 Millwood Ave Columbia SC 29205-1218 Ph: (803) 788-0038 |
| NPI Number | 1699280644 |
|---|---|
| Provider Enumeration Date | 12/12/2017 |
| Last Update Date | 12/13/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699280644 | NPI | - | NPPES |
| GP1403 | Medicaid | SC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084A0401X | Psychiatry & Neurology - Addiction Medicine | 18323 (South Carolina) | Primary |
| 324500000X | Substance Abuse Rehabilitation Facility | 18323 (South Carolina) | Secondary |
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