MEDICARE: ONENGIYA HARRY M.D., MPH, MSC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2080P0216X	Pediatric Rheumatology Physician	201001868	NC
2	208000000X	Pediatrics Physician	201001868	NC

General Provider Information

NPI Number	:	1114190774
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ONENGIYA HARRY M.D., MPH, MSC

Provider Business Mailing Address
First Line	:	ONE MEDICAL CENTER BLVD
Second Line	:
City	:	WINSTON SALEM
State	:	NC
Zip	:	27157-0001
Country	:	US
Telephone Number	:	336-713-4500
Fax Number	:	336-713-4501

Provider Business Practice Location Address
First Line	:	ONE MEDICAL CENTER BOULEVARD 3RD FLOOR MEADS HALL
Second Line	:
City	:	WINSTON SALEM
State	:	NC
Zip	:	27157-3026
Country	:	US
Telephone Number	:	336-713-4500
Fax Number	:	336-713-4501

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/03/2008
Last Update Date	:	07/15/2022

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