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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