Healthcare Provider Details

I. General information

NPI: 1114190774
Provider Name (Legal Business Name): ONENGIYA HARRY M.D., MPH, MSC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/03/2008
Last Update Date: 07/15/2022
Certification Date: 07/15/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

ONE MEDICAL CENTER BOULEVARD 3RD FLOOR MEADS HALL
WINSTON SALEM NC
27157-3026
US

IV. Provider business mailing address

ONE MEDICAL CENTER BLVD
WINSTON SALEM NC
27157-0001
US

V. Phone/Fax

Practice location:
  • Phone: 336-713-4500
  • Fax: 336-713-4501
Mailing address:
  • Phone: 336-713-4500
  • Fax: 336-713-4501

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number201001868
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code2080P0216X
TaxonomyPediatric Rheumatology Physician
License Number201001868
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: