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Organization
NOVANT MEDICAL GROUP, INC.
Active
Organization
NOVANT MEDICAL GROUP, INC.
Active
Other names
Novant Health Colon and Rectal Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
GEOFFREY K. GARDNER (VP OF FINANCE)
(704) 384-9094
Entity
Organization
Contact information
Practice address
1710 KERNERSVILLE MEDICAL PKWY, SUITE 202, KERNERSVILLE, NC 27284-7146
(336) 564-4873
(336) 992-2170
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
(336) 564-4873
(336) 992-2170
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
—
NULL
208600000X
Surgery Physician
—
—
208C00000X
Colon & Rectal Surgery Physician
Primary
—
NULL
208C00000X
Colon & Rectal Surgery Physician
Primary
—
—
Other
Enumeration date
02/07/2013
Last updated
03/11/2015
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