MEDICARE: CAPITAL SPINE AND PAIN INSTITUTE PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207T00000X	Neurological Surgery Physician

General Provider Information

NPI Number	:	1972432433
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CAPITAL SPINE AND PAIN INSTITUTE PLLC

Provider Business Mailing Address
First Line	:	6244A LITTLE RIVER TPKE
Second Line	:
City	:	ALEXANDRIA
State	:	VA
Zip	:	22312-1714
Country	:	US
Telephone Number	:	571-399-6340
Fax Number	:

Provider Business Practice Location Address
First Line	:	6244A LITTLE RIVER TPKE
Second Line	:
City	:	ALEXANDRIA
State	:	VA
Zip	:	22312-1714
Country	:	US
Telephone Number	:	571-399-6340
Fax Number	:

Authorized Official
Title or Position	:	MD
Name	:	AVERY BUCHHOLZ
Credential	:	MD
Telephone Number	:	571-399-6340

Provider Enumeration Date	:	05/19/2026
Last Update Date	:	05/19/2026

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Directions to “CAPITAL SPINE AND PAIN INSTITUTE PLLC ” Practice Location

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