Organization
NOVANT HEALTH MEDICAL GROUP, LLC
Active
Other names
Novant Health Monroe Family Medical
Organization subpart
No
Provider details
NPI number
Authorized official
LEEA JEANINE WALTON (RCS MANAGER)
(704) 316-6081
Entity
Organization
Contact information
Practice address
1420 E FRANKLIN ST, MONROE, NC 28112-5160
(704) 289-8427
(704) 283-5522
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
(704) 289-8427
(704) 283-5522
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
019J9
BCBS OF NC
NC
05
—
5906999
—
NC
01
—
DG5586
RAILROAD MEDICARE
NC
Enumeration date
07/05/2007
Last updated
07/09/2024
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