# NOVANT MEDICAL GROUP INC.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Novant Health Blue Ridge Medical Associates
- **Organization subpart:** No

## Provider details

- **NPI number:** 1750788659
- **Authorized official:** GEOFFREY K GARDNER (VP OF FINANCE)
- **Authorized official phone:** (704) 384-7203

## Contact information

- **Practice address:** 301 EXECUTIVE PARK BLVD, WINSTON SALEM, NC 27103-1505
- **Practice address phone:** (336) 774-9000
- **Practice address fax:** (336) 774-9012
- **Mailing address:** PO BOX 60447, CHARLOTTE, NC 28260-0447
- **Mailing address phone:** (336) 774-9000

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207V00000X | Obstetrics & Gynecology Physician | — | NULL | Yes |
| 207V00000X | Obstetrics & Gynecology Physician | — | — | Yes |

## Other

- **Enumeration date:** 11/21/2014
- **Last updated:** 11/21/2014