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Organization
NOVANT HEALTH MEDICAL GROUP, LLC
Active
Organization
NOVANT HEALTH MEDICAL GROUP, LLC
Active
Other names
Novant Health Endocrinology
Organization subpart
No
Provider details
NPI number
Authorized official
LEEA JEANINE WALTON (RCS MANAGER)
(704) 316-6081
Entity
Organization
Contact information
Practice address
1918 RANDOLPH RD, SUITE 220, CHARLOTTE, NC 28207-1109
(704) 316-1125
(704) 316-1143
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
(704) 316-1125
(704) 316-1143
Taxonomy
Speciality
Code
Description
License number
State
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0277F
BCBS NC
NC
05
—
790277F
—
NC
01
—
CC5118
RAILROAD MEDICARE
NC
05
—
NPA896
—
SC
Enumeration date
08/18/2006
Last updated
07/11/2024
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