# NOVANT MEDICAL GROUP, INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Davidson Ears, Nose, Throat (Kernersville)
- **Organization subpart:** No

## Provider details

- **NPI number:** 1750657003
- **Authorized official:** MR. GEOFFREY K GARDNER (VP FINANCE, NMG)
- **Authorized official phone:** (704) 384-9094

## Contact information

- **Practice address:** 1750 KERNERSVILLE MEDICAL PKWY, KERNERSVILLE, NC 27284-7146
- **Practice address phone:** (336) 472-1300
- **Practice address fax:** (336) 472-1302
- **Mailing address:** PO BOX 60447, CHARLOTTE, NC 28260-0447
- **Mailing address phone:** (704) 384-7840

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Y00000X | Otolaryngology Physician | — | NULL | Yes |
| 207Y00000X | Otolaryngology Physician | — | — | Yes |

## Other

- **Enumeration date:** 03/30/2012
- **Last updated:** 03/30/2012