# NOVANT HEALTH MEDICAL GROUP COASTAL REGION, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Novant Health Family Medicine Rocky Point, Pender Primary Care - Rocky Point
- **Organization subpart:** No

## Provider details

- **NPI number:** 1407436934
- **Authorized official:** SHALA DAVIS (RCS MANAGER)
- **Authorized official phone:** (704) 303-7517

## Contact information

- **Practice address:** 7910 US HWY 117 S UNIT 120, ROCKY POINT, NC 28457-7409
- **Practice address phone:** (910) 300-4500
- **Practice address fax:** (910) 675-3030
- **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:** 04/09/2021
- **Last updated:** 12/06/2022