Organization
KAIROS WELLNESS INITIATIVE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
OBINNA IKWECHEGH MD (OWNER)
(336) 293-4107
Entity
Organization
Contact information
Practice address
3000 BETHESDA PL STE 202, WINSTON SALEM, NC 27103-3324
(336) 293-4107
(949) 577-4324
Mailing address
3000 BETHESDA PL STE 104, WINSTON SALEM, NC 27103-3323
(336) 293-4107
(949) 577-4324
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1346268745
CHARLES DUNHAM
NC
01
—
1790385326
LEILONI MULLIGAN
NC
01
—
1881108009
CHUE BLACK
NC
01
—
1952582967
OBINNA IKWECHEGH
NC
Enumeration date
07/26/2021
Last updated
07/26/2021
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