Provider Demographics
NPI:1891302998
Name:APOLLO SPINE AND PAIN CENTER
Entity Type:Organization
Organization Name:APOLLO SPINE AND PAIN CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:RAMYA
Authorized Official - Middle Name:NAGARAJAN
Authorized Official - Last Name:RANGARAJ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:678-771-8266
Mailing Address - Street 1:4415 FRONT NINE DR STE 700
Mailing Address - Street 2:
Mailing Address - City:CUMMING
Mailing Address - State:GA
Mailing Address - Zip Code:30041-6239
Mailing Address - Country:US
Mailing Address - Phone:678-771-8266
Mailing Address - Fax:678-456-8814
Practice Address - Street 1:4415 FRONT NINE DR
Practice Address - Street 2:
Practice Address - City:CUMMING
Practice Address - State:GA
Practice Address - Zip Code:30041-6063
Practice Address - Country:US
Practice Address - Phone:614-905-2700
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-23
Last Update Date:2021-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Single Specialty