Provider Demographics
NPI:1396504544
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:CEO
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:803-933-6134
Mailing Address - Street 1:1825 BLANDING ST
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29201-3517
Mailing Address - Country:US
Mailing Address - Phone:803-256-4107
Mailing Address - Fax:
Practice Address - Street 1:1825 BLANDING ST
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29201-3517
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:2024-03-18
Last Update Date:2024-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain MedicineGroup - Multi-Specialty
No207T00000XAllopathic & Osteopathic PhysiciansNeurological SurgeryGroup - Multi-Specialty
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty