Healthcare Provider Details

I. General information

NPI: 1194780486
Provider Name (Legal Business Name): HOMA MAGSI M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/19/2006
Last Update Date: 05/04/2021
Certification Date: 05/04/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1801 WESTCHESTER DR
HIGH POINT NC
27262-7009
US

IV. Provider business mailing address

1801 WESTCHESTER DR
HIGH POINT NC
27262-7009
US

V. Phone/Fax

Practice location:
  • Phone: 336-889-8446
  • Fax: 336-878-7275
Mailing address:
  • Phone: 336-889-8446
  • Fax: 336-878-7275

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number122030
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number47232
License Number StateWI
# 3
Primary TaxonomyN
Taxonomy Code207QH0002X
TaxonomyHospice and Palliative Medicine (Family Medicine) Physician
License NumberME135364
License Number StateFL
# 4
Primary TaxonomyY
Taxonomy Code207QH0002X
TaxonomyHospice and Palliative Medicine (Family Medicine) Physician
License Number2020-03937
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: