MEDICARE: WENG ON HO RD, LDN, CSR

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	133V00000X	Registered Dietitian	L003783	NC
2	133VN1005X	Renal Nutrition Registered Dietitian	L003783	NC

General Provider Information

NPI Number	:	1396219747
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WENG ON HO RD, LDN, CSR

Provider Business Mailing Address
First Line	:	9622 KINCEY AVE
Second Line	:
City	:	HUNTERSVILLE
State	:	NC
Zip	:	28078-9140
Country	:	US
Telephone Number	:	704-912-3890
Fax Number	:	800-426-0743

Provider Business Practice Location Address
First Line	:	9622 KINCEY AVE
Second Line	:
City	:	HUNTERSVILLE
State	:	NC
Zip	:	28078-9140
Country	:	US
Telephone Number	:	704-912-3890
Fax Number	:	800-426-0743

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

Provider Enumeration Date	:	01/18/2019
Last Update Date	:	05/05/2026

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Directions to “ WENG ON HO RD, LDN, CSR” Practice Location

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