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Organization
NOVANT MEDICAL GROUP, INC.
Active
Organization
NOVANT MEDICAL GROUP, INC.
Active
Other names
Family Medicine at Revolution Mill
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GEOFFREY K GARDNER (VP OF FINANCE)
(704) 384-9094
Entity
Organization
Contact information
Practice address
1591 YANCEYVILLE ST, SUITE 200, GREENSBORO, NC 27405-6941
(336) 232-0180
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
(704) 384-7840
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5950463
—
NC
Enumeration date
10/10/2008
Last updated
03/29/2010
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