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Individual

DR. ELEANYA OGBURU-OGBONNAYA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
2601 MILLWOOD AVE, COLUMBIA, SC 29205-1218
(803) 788-0038
(803) 788-0655
Mailing address
PO BOX 209, STATE PARK, SC 29147-0209
(803) 788-0038
(803) 788-0655

Taxonomy

Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
18323
SC
208VP0014X
Interventional Pain Medicine Physician
18323
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
T23356
SC
Enumeration date
10/29/2007
Last updated
09/25/2014
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