# NOVANT MEDICAL GROUP, INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Novant Health Archdale Family Medicine
- **Organization subpart:** No

## Provider details

- **NPI number:** 1417362781
- **Authorized official:** GEOFFREY K GARDNER (VP OF FINANCE)
- **Authorized official phone:** (704) 384-7606

## Contact information

- **Practice address:** 1718 EAST 4TH STREET, SUITE 401, CHARLOTTE, NC 28260-0447
- **Practice address phone:** (336) 564-4161
- **Practice address fax:** (336) 431-0084
- **Mailing address:** PO BOX 60447, CHARLOTTE, NC 28260-0447
- **Mailing address phone:** (336) 564-4161
- **Mailing address fax:** (336) 431-0084

## Taxonomy

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

## Other

- **Enumeration date:** 06/25/2014
- **Last updated:** 08/05/2014