Organization
NOVANT MEDICAL GROUP, INC.
Active
Organization
NOVANT MEDICAL GROUP, INC.
Active
Parent organization
NOVANT MEDICAL GROUP, INC.
Other names
Novant Health Durham Internal Medicine Southpoint
Organization subpart
Yes
Provider details
NPI number
Legal business name
NOVANT MEDICAL GROUP, INC.
Authorized official
SHALA DAVIS (RCS MGR)
(704) 303-7517
Entity
Organization
Contact information
Practice address
5107 SOUTHPARK DR, SUITE 104, DURHAM, NC 27713-8400
(919) 477-6900
(919) 544-6210
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
(919) 477-6900
(919) 544-6210
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5908373
—
NC
Enumeration date
05/06/2008
Last updated
08/18/2021
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