Organization
NOVANT MEDICAL GROUP, INC.
Active
Other names
Novant Health Internal Medicine Providence
Organization subpart
No
Provider details
NPI number
Authorized official
SHALA DAVIS (RCS MGR)
(704) 303-7517
Entity
Organization
Contact information
Practice address
7903 PROVIDENCE RD STE 100, CHARLOTTE, NC 28277-9763
(704) 384-7680
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Enumeration date
04/12/2018
Last updated
08/18/2021
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