Healthcare Provider Details

I. General information

NPI: 1558075325
Provider Name (Legal Business Name): YOJI OGURA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/06/2023
Last Update Date: 10/13/2025
Certification Date: 10/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

131 MILLER ST
WINSTON SALEM NC
27103-2508
US

IV. Provider business mailing address

131 MILLER ST
WINSTON SALEM NC
27103-2508
US

V. Phone/Fax

Practice location:
  • Phone: 336-716-8200
  • Fax:
Mailing address:
  • Phone: 336-716-8200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XS0117X
TaxonomyOrthopaedic Surgery of the Spine Physician
License Number2025-02739
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: