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Organization

NOVANT HEALTH MEDICAL GROUP COASTAL REGION, LLC

Active
Other names
NHMGCR GYN ONC
Organization subpart
No

Provider details

NPI number
Authorized official
SHALA DAVIS (RCS MANAGER)
(704) 303-7517
Entity
Organization

Contact information

Practice address
2131 S 17TH ST, WILMINGTON, NC 28401-7407
(910) 667-5830
Mailing address
PO BOX 936857, ATLANTA, GA 31193-6857

Taxonomy

Speciality
Code
Description
License number
State
207VX0201X
Gynecologic Oncology Physician
Primary

Other

Enumeration date
03/01/2021
Last updated
07/19/2021
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