Healthcare Provider Details

I. General information

NPI: 1316147150
Provider Name (Legal Business Name): KAREN MARGHANITA AQUINO M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/19/2007
Last Update Date: 08/10/2021
Certification Date: 08/10/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 E WENDOVER AVE SUITE 310
GREENSBORO NC
27401-1230
US

IV. Provider business mailing address

301 E WENDOVER AVE SUITE 310
GREENSBORO NC
27401-1230
US

V. Phone/Fax

Practice location:
  • Phone: 336-832-3070
  • Fax: 336-832-3075
Mailing address:
  • Phone: 336-832-3070
  • Fax: 336-832-3075

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number2014-02456
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License NumberP2947
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: