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Organization
NOVANT HEALTH MEDICAL GROUP, LLC
Active
Organization
NOVANT HEALTH MEDICAL GROUP, LLC
Active
Other names
Novant Health Cotswold Medical Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
LEEA JEANINE WALTON (RCS MANAGER)
(704) 316-6081
Entity
Organization
Contact information
Practice address
200 GREENWICH RD, CHARLOTTE, NC 28211-2316
(704) 384-8680
(704) 384-8684
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
(704) 384-7603
(704) 417-4479
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0271V
BCBS-NC
NC
05
—
890271V
—
NC
01
—
CC5118
RAILROAD MEDICARE
NC
Enumeration date
05/25/2006
Last updated
07/09/2024
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