# NOVANT HEALTH MEDICAL GROUP COASTAL REGION, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Wrightsville Beach Family Medicine
- **Organization subpart:** No

## Provider details

- **NPI number:** 1326628306
- **Authorized official:** SHALA DAVIS (RCS MANAGER)
- **Authorized official phone:** (704) 316-7845

## Contact information

- **Practice address:** 1721 ALLENS LN STE 100, WILMINGTON, NC 28403-3662
- **Practice address phone:** (910) 344-8900
- **Mailing address:** PO BOX 936857, ATLANTA, GA 31193-6857

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 04/13/2021
- **Last updated:** 04/13/2021