Organization
NOVANT HEALTH MEDICAL GROUP, LLC
Active
Other names
Novant Health Crown Point Family Physican
Organization subpart
No
Provider details
NPI number
Authorized official
LEEA JEANINE WALTON (RCS MANAGER)
(704) 316-6081
Entity
Organization
Contact information
Practice address
9101 MONROE RD, SUITE 155, CHARLOTTE, NC 28270-2467
(704) 384-1260
(704) 384-1289
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
(704) 384-1260
(704) 384-1289
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0272Y
BCBS
NC
05
—
890272Y
—
NC
Enumeration date
05/24/2006
Last updated
07/09/2024
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