# NOVANT MEDICAL GROUP INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Novant Health Sleep Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1184040024
- **Authorized official:** MR. GEOFFREY KEITH GARDNER (VP FINANCE)
- **Authorized official phone:** (704) 384-7603

## Contact information

- **Practice address:** 3333 SILAS CREEK PKWY, WINSTON SALEM, NC 27103-3013
- **Practice address phone:** (704) 384-7603
- **Mailing address:** PO BOX 60447, CHARLOTTE, NC 28260-0447
- **Mailing address phone:** (704) 384-7840

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207RC0000X | Cardiovascular Disease Physician | — | NULL | — |
| 207RC0000X | Cardiovascular Disease Physician | — | — | — |
| 207RC0200X | Critical Care Medicine (Internal Medicine) Physician | — | NULL | — |
| 207RC0200X | Critical Care Medicine (Internal Medicine) Physician | — | — | — |
| 207RS0012X | Sleep Medicine (Internal Medicine) Physician | — | NULL | Yes |
| 207RS0012X | Sleep Medicine (Internal Medicine) Physician | — | — | Yes |
| 2080S0012X | Pediatric Sleep Medicine Physician | — | NULL | — |
| 2080S0012X | Pediatric Sleep Medicine Physician | — | — | — |
| 2084S0012X | Sleep Medicine (Psychiatry & Neurology) Physician | — | NULL | — |
| 2084S0012X | Sleep Medicine (Psychiatry & Neurology) Physician | — | — | — |

## Other

- **Enumeration date:** 03/17/2014
- **Last updated:** 03/17/2014