# 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:** 1265870026
- **Authorized official:** GEOFFREY GARDNER (VP OF FINANCE)
- **Authorized official phone:** (704) 384-7603

## Contact information

- **Practice address:** 14215 BALLANTYNE CORPORATE PL, SUITE 240, CHARLOTTE, NC 28277-3670
- **Practice address phone:** (704) 316-5000
- **Practice address fax:** (704) 316-5010
- **Mailing address:** PO BOX 60447, CHARLOTTE, NC 28260-0447
- **Mailing address phone:** (704) 316-5000
- **Mailing address fax:** (704) 316-5010

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207RC0000X | Cardiovascular Disease Physician | — | NULL | — |
| 207RC0000X | Cardiovascular Disease Physician | — | — | — |
| 207RP1001X | Pulmonary Disease Physician | — | NULL | — |
| 207RP1001X | Pulmonary Disease Physician | — | — | — |
| 207RS0012X | Sleep Medicine (Internal Medicine) Physician | — | NULL | Yes |
| 207RS0012X | Sleep Medicine (Internal Medicine) Physician | — | — | Yes |
| 2084N0400X | Neurology Physician | — | NULL | — |
| 2084N0400X | Neurology Physician | — | — | — |

## Other

- **Enumeration date:** 06/13/2013
- **Last updated:** 06/19/2013