Organization
NOVANT HEALTH MEDICAL GROUP, LLC
Active
Other names
Novant Health Orthopedics & Sports Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
LEEA JEANINE WALTON (RCS MANAGER)
(704) 316-6081
Entity
Organization
Contact information
Practice address
4741 RANDOLPH RD STE 100 & STE 200, CHARLOTTE, NC 28211-2919
(704) 365-6730
(704) 365-6731
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
(704) 384-7840
(704) 384-7830
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
018R5
BCBS-NC
NC
01
—
156893912
US DEPT. OF LABOR
NC
05
—
5905841
—
NC
05
—
NPB211
—
SC
Enumeration date
12/27/2006
Last updated
07/11/2024
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