Provider Demographics
NPI:1740417906
Name:OXENDINE, TONI CHAGOLLA (MD)
Entity Type:Individual
Prefix:
First Name:TONI
Middle Name:CHAGOLLA
Last Name:OXENDINE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5221 PARAMOUNT PKWY STE 220
Mailing Address - Street 2:
Mailing Address - City:MORRISVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27560-5490
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:923 W 3RD ST
Practice Address - Street 2:
Practice Address - City:PEMBROKE
Practice Address - State:NC
Practice Address - Zip Code:28372-9628
Practice Address - Country:US
Practice Address - Phone:910-521-0564
Practice Address - Fax:910-521-8091
Is Sole Proprietor?:No
Enumeration Date:2009-06-16
Last Update Date:2024-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2013-01392208000000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1740417906OtherUNITEDHEALTHCARE
NC5647743OtherAETNA PROVIDER NUMBER
NC1740417906OtherMEDCOST
NC1740417906Medicaid
NC1740417906OtherHEALTHNET/TRICARE
NC1740417906OtherBCBSNC
NCFH1101500OtherFIRSTCAROLINACARE
NC1740417906OtherCIGNA
NC1740417906OtherCOVENTRY/WELLPATH
NC1740417906Medicaid