Organization
NOVANT HEALTH MEDICAL GROUP LLC
Active
Other names
Novant Health GCM Children's Collaborative Care
Organization subpart
No
Provider details
NPI number
Authorized official
LEEA JEANINE WALTON (MANAGER)
(047) 316-6081
Entity
Organization
Contact information
Practice address
2711 RANDOLPH RD STE 100, CHARLOTTE, NC 28207-2027
(704) 000-0000
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
—
—
Other
Enumeration date
12/04/2024
Last updated
01/23/2025
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