# NOVANT HEALTH MEDICAL GROUP, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Novant Health Providence OB/GYN
- **Organization subpart:** No

## Provider details

- **NPI number:** 1881015089
- **Authorized official:** LEEA JEANINE WALTON (RCS MANAGER)
- **Authorized official phone:** (704) 316-6081

## Contact information

- **Practice address:** 13557 STEELECROFT PKWY, SUITE 2100, CHARLOTTE, NC 28278-7559
- **Practice address phone:** (704) 384-7900
- **Practice address fax:** (704) 384-7907
- **Mailing address:** PO BOX 60447, CHARLOTTE, NC 28260-0447
- **Mailing address phone:** (704) 384-7900

## Taxonomy

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

## Other

- **Enumeration date:** 12/16/2013
- **Last updated:** 06/20/2024