Organization
NOVANT MEDICAL GROUP, INC.
Active
Other names
Mint Hill Family Practice
Organization subpart
No
Provider details
NPI number
Authorized official
DINESH S. PAI (VP OF OPERATIONS)
(704) 384-9113
Entity
Organization
Contact information
Practice address
11304 HAWTHORNE DR, SUITE 100, CHARLOTTE, NC 28227
(704) 384-8760
(704) 384-8783
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
(704) 384-7607
(704) 316-0508
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0275V
BCBS-NC
NC
05
—
890275V
—
NC
01
—
CC5118
RAILROAD MEDICARE
NC
Enumeration date
05/16/2006
Last updated
08/15/2008
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