# MIDLANDS NEUROLOGY & PAIN ASSOC, P.A

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1699280644
- **Authorized official:** ELEANYA OGBURU-OGBONNAYA MD (PRESIDENT CEO)
- **Authorized official phone:** (803) 788-0038

## Contact information

- **Practice address:** 2601 MILLWOOD AVE, COLUMBIA, SC 29205-1218
- **Practice address phone:** (803) 788-0038
- **Mailing address:** PO BOX 209, STATE PARK, SC 29147-0209

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2084A0401X | Addiction Medicine (Psychiatry & Neurology) Physician | 18323 | SC | Yes |
| 324500000X | Substance Abuse Rehabilitation Facility | 18323 | SC | — |

## Other

- **Enumeration date:** 12/12/2017
- **Last updated:** 12/13/2017