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Organization
MIDLANDS NEUROLOGY & PAIN ASSOC, P.A
Active
Organization
MIDLANDS NEUROLOGY & PAIN ASSOC, P.A
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ELEANYA OGBURU-OGBONNAYA MD (PRESIDENT CEO)
(803) 788-0038
Entity
Organization
Contact information
Practice address
2601 MILLWOOD AVE, COLUMBIA, SC 29205-1218
(803) 788-0038
Mailing address
PO BOX 209, STATE PARK, SC 29147-0209
Taxonomy
Speciality
Code
Description
License number
State
2084A0401X
Addiction Medicine (Psychiatry & Neurology) Physician
Primary
18323
SC
324500000X
Substance Abuse Rehabilitation Facility
18323
SC
Other
Enumeration date
12/12/2017
Last updated
12/13/2017
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