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Organization
NOVANT MEDICAL GROUP, INC.
Active
Organization
NOVANT MEDICAL GROUP, INC.
Active
Other names
Novant Health Fort Mill Family Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
GEOFFREY GARDNER (VP OF OPERATIONS)
(704) 384-9094
Entity
Organization
Contact information
Practice address
1690 HIGHWAY 160 W, FORT MILL, SC 29708-8024
(803) 547-7541
(803) 548-0122
Mailing address
PO BOX 602362, CHARLOTTE, NC 28260-2362
(704) 384-7840
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GP4288
—
SC
Enumeration date
04/06/2006
Last updated
06/27/2013
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