Provider Demographics
NPI:1679100564
Name:SUBACH SPINAL SOLUTIONS, PLC
Entity type:Organization
Organization Name:SUBACH SPINAL SOLUTIONS, PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:R
Authorized Official - Last Name:SUBACH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:703-795-4935
Mailing Address - Street 1:7301 DULANY DR
Mailing Address - Street 2:
Mailing Address - City:MC LEAN
Mailing Address - State:VA
Mailing Address - Zip Code:22101-2714
Mailing Address - Country:US
Mailing Address - Phone:703-795-4837
Mailing Address - Fax:
Practice Address - Street 1:1635 N GEORGE MASON DR STE 150
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22205-3679
Practice Address - Country:US
Practice Address - Phone:571-732-0044
Practice Address - Fax:866-850-1049
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SUBACH SPINAL SOLUTIONS, PLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-03-23
Last Update Date:2020-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological SurgeryGroup - Multi-Specialty
No207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Multi-Specialty