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Organization
NOVANT MEDICAL GROUP, INC.
Active
Organization
NOVANT MEDICAL GROUP, INC.
Active
Other names
Novant Urgent Care Shallotte
Organization subpart
No
Provider details
NPI number
Authorized official
GEOFFREY GARDNER (VP OF OPERATIONS)
(704) 384-9094
Entity
Organization
Contact information
Practice address
4503 MAIN STREET, SHALLOTTE, NC 28470-4447
(910) 755-5440
(910) 755-5420
Mailing address
PO BOX 602362, CHARLOTTE, NC 28260-2362
(704) 384-7840
Taxonomy
Speciality
Code
Description
License number
State
261QU0200X
Urgent Care Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
020C5
BCBS-NC
NC
05
—
5909127
—
NC
Enumeration date
09/13/2007
Last updated
07/19/2011
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