Individual
OMADITYA KHANNA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
MEDICAL CENTER BLVD, WINSTON SALEM, NC 27157-5211
(336) 716-4081
(336) 716-3065
Mailing address
100 KIMEL FOREST DR, WINSTON SALEM, NC 27103-6074
(336) 716-0238
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
2024-02336
NC
207T00000X
Neurological Surgery Physician
DR.0070493
CO
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/08/2016
Last updated
08/20/2024
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