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Organization
NOVANT MEDICAL GROUP, INC.
Active
Organization
NOVANT MEDICAL GROUP, INC.
Active
Other names
Sunset Beach Family Medical
Organization subpart
No
Provider details
NPI number
Authorized official
DINESH S. PAI (VP OF OPERATIONS)
(704) 384-9104
Entity
Organization
Contact information
Practice address
710 SUNSET BLVD N, SUITE B, SUNSET BEACH, NC 28468-4345
(910) 575-0006
(910) 575-3972
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
(704) 384-9679
(704) 316-0508
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
018PA
BCBS NC
NC
05
—
5905835
—
NC
Enumeration date
11/14/2006
Last updated
02/11/2009
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