Healthcare Provider Details

I. General information

NPI: 1174985451
Provider Name (Legal Business Name): NICHOLAS ROBERT DEGNER MD, MPH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/24/2016
Last Update Date: 05/26/2026
Certification Date: 05/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

MEDICAL CENTER BOULEVARD
WINSTON SALEM NC
27157-0001
US

IV. Provider business mailing address

14211 HARVINGTON DR
HUNTERSVILLE NC
28078-2268
US

V. Phone/Fax

Practice location:
  • Phone: 336-716-4070
  • Fax:
Mailing address:
  • Phone: 619-865-0546
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number331054
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License Number331054
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: