# SHALOM PEDIATRIC CLINIC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1316227739
- **Authorized official:** DR. RITA OBIAGELI NNAEMEKAOKOYEH MD (MEDICAL DIRECTOR)
- **Authorized official phone:** (336) 574-8355

## Contact information

- **Practice address:** 2806 RANDLEMAN RD, SUITE M, GREENSBORO, NC 27406-5265
- **Practice address phone:** (336) 574-8355
- **Practice address fax:** (336) 273-9192
- **Mailing address:** 2806 RANDLEMAN RD, SUITE M, GREENSBORO, NC 27406-5265
- **Mailing address phone:** (336) 574-8355
- **Mailing address fax:** (336) 273-9192

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QP2300X | Primary Care Clinic/Center | 2005-01548 | NC | Yes |

## Other

- **Enumeration date:** 08/17/2011
- **Last updated:** 08/17/2011