Sangueza, Omar Pastor

Sangueza, Omar Pastor is an individual health care provider with primary practice located at Medical Center Blvd , Winston Salem NC 27157-0001. He recently has only one registered license in Allopathic & Osteopathic Physicians / Dermatopathology, which is considered as his primary health care specialty. Sangueza, Omar Pastor can be contacted via phone (336) 716-2255.

Contact Information

Primary practice address
Medical Center Blvd Winston Salem NC 27157-0001
Phone: (336) 716-2255
Fax: (336) 716-7595
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Dermatopathology 207ZD0900X 200000967 North Carolina

Profile Details

NPI number 1770569436
LBN Legal business name Sangueza, Omar Pastor
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 15th, 2005
Last updated Sep 23rd, 2010 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1770569436 NPPES
Virginia MEDICAID 006607080
Virginia MEDICAID 89126MP
Virginia MEDICAID 006600531
Virginia MEDICAID G40302

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