Healthcare Provider Details

I. General information

NPI: 1164050506
Provider Name (Legal Business Name): ROMESA BINT AMEEN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/31/2020
Last Update Date: 05/04/2026
Certification Date: 05/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2101 PETERS CREEK PKWY STE 16-19
WINSTON SALEM NC
27127-3726
US

IV. Provider business mailing address

PO BOX 12341
WINSTON SALEM NC
27117-2341
US

V. Phone/Fax

Practice location:
  • Phone: 336-955-1379
  • Fax:
Mailing address:
  • Phone: 336-955-1379
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number2023-02522
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: