Organization
NOVANT HEALTH MEDICAL GROUP, LLC
Active
Other names
Novant Health Premier Dermatology
Organization subpart
No
Provider details
NPI number
Authorized official
LEEA JEANINE WALTON (RCS MANAGER)
(704) 316-6081
Entity
Organization
Contact information
Practice address
2025 FRONTIS PLAZA BLVD STE 120, WINSTON SALEM, NC 27103-5663
(336) 774-3740
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
Other
Enumeration date
01/14/2025
Last updated
02/10/2025
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