Organization
CAPITAL BRAIN CENTER, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SUBBA M RAO M.D (OWNER)
(803) 551-2900
Entity
Organization
Contact information
Practice address
2800 BUSH RIVER RD STE 5, COLUMBIA, SC 29210-5662
(803) 551-2900
(803) 551-2979
Mailing address
PO BOX 9426, COLUMBIA, SC 29290-9426
(803) 551-2900
(803) 551-2979
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
23617
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
236177
—
SC
Enumeration date
03/01/2007
Last updated
08/22/2020
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