Organization
NOVANT MEDICAL GROUP, INC.
Active
Organization
NOVANT MEDICAL GROUP, INC.
Active
Other names
Novant Health Pediatric Nephrology
Organization subpart
No
Provider details
NPI number
Authorized official
SHALA DAVIS (ENROLLMENT MANAGER)
(704) 316-7845
Entity
Organization
Contact information
Practice address
1401 MATTHEWS TOWNSHIP PKWY STE 100, MATTHEWS, NC 28105-5403
(704) 316-5910
(704) 316-5911
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
Taxonomy
Speciality
Code
Description
License number
State
2080P0210X
Pediatric Nephrology Physician
Primary
—
—
Other
Enumeration date
01/03/2020
Last updated
01/03/2020
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