Provider Demographics
NPI: | 1184455925 |
---|---|
Name: | MIDLANDS ORTHOPAEDICS AND NEUROSURGERY, PA |
Entity type: | Organization |
Organization Name: | MIDLANDS ORTHOPAEDICS AND NEUROSURGERY, PA |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | DIRECTER |
Authorized Official - Prefix: | |
Authorized Official - First Name: | ANN |
Authorized Official - Middle Name: | MARGARET |
Authorized Official - Last Name: | MCCRAW |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 803-933-6687 |
Mailing Address - Street 1: | 1910 BLANDING ST |
Mailing Address - Street 2: | |
Mailing Address - City: | COLUMBIA |
Mailing Address - State: | SC |
Mailing Address - Zip Code: | 29201-3520 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 803-256-4107 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 720 RABON RD |
Practice Address - Street 2: | |
Practice Address - City: | COLUMBIA |
Practice Address - State: | SC |
Practice Address - Zip Code: | 29203-8900 |
Practice Address - Country: | US |
Practice Address - Phone: | 803-256-4107 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | Yes |
Parent Organization LBN: | MIDLANDS ORTHOPAEDICS AND NEUROSURGERY, PA |
Parent Organization TIN: | <UNAVAIL> |
Enumeration Date: | 2024-08-13 |
Last Update Date: | 2024-08-13 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 207X00000X | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | Group - Multi-Specialty | |
No | 207T00000X | Allopathic & Osteopathic Physicians | Neurological Surgery | Group - Multi-Specialty | |
No | 207XX0005X | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | Sports Medicine | Group - Multi-Specialty |
No | 224Z00000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapy Assistant | Group - Multi-Specialty | |
No | 225100000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Group - Multi-Specialty | |
No | 225200000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapy Assistant | Group - Multi-Specialty | |
No | 225X00000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | Group - Multi-Specialty | |
No | 261QM1300X | Ambulatory Health Care Facilities | Clinic/Center | Multi-Specialty | Group - Multi-Specialty |
No | 332B00000X | Suppliers | Durable Medical Equipment & Medical Supplies | ||
No | 363A00000X | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | Group - Multi-Specialty | |
No | 363AS0400X | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | Surgical | Group - Multi-Specialty |