# NOVANT HEALTH MEDICAL GROUP COASTAL REGION, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1316873664
- **Authorized official:** LEEA JEANINE WALTON (ENROLLMENT MANAGER)
- **Authorized official phone:** (336) 515-7085

## Contact information

- **Practice address:** 1509 DOCTORS CIR BLDG C, WILMINGTON, NC 28401-7403
- **Practice address phone:** (910) 662-7500
- **Practice address fax:** (910) 662-7501
- **Mailing address:** PO BOX 936857, ATLANTA, GA 31193-6857
- **Mailing address phone:** (910) 662-7500
- **Mailing address fax:** (910) 662-7501

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | NULL | Yes |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | — | Yes |

## Other

- **Enumeration date:** 06/23/2026
- **Last updated:** 06/23/2026