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NPI Code Detail

MEDICARE: WENG ON HO RD, LDN, CSR

MEDICARE:   WENG ON  HO  RD, LDN, CSR
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
1133V00000XRegistered DietitianL003783NC
2133VN1005XRenal Nutrition Registered DietitianL003783NC

General Provider Information

NPI Number : 1396219747
Entity Type Code : Individual
Provider Name (Legal Business Name) : WENG ON HO RD, LDN, CSR
Provider Business Mailing Address
First Line : 5627 ALBEMARLE RD
Second Line :
City : CHARLOTTE
State : NC
Zip : 28212-3611
Country : US
Telephone Number : 704-535-3962
Fax Number :
Provider Business Practice Location Address
First Line : 5627 ALBEMARLE RD
Second Line :
City : CHARLOTTE
State : NC
Zip : 28212-3611
Country : US
Telephone Number : 704-535-3962
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/18/2019
Last Update Date : 01/18/2019

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Directions to “ WENG ON HO RD, LDN, CSR” Practice Location

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