Organization
NOVANT HEALTH MEDICAL GROUP COASTAL REGION, LLC
Active
Other names
Novant Health Psychiatry Residency Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
LEEA JEANINE WALTON (ENROLLMENT MANAGER)
(336) 515-7085
Entity
Organization
Contact information
Practice address
416 N 30TH ST, WILMINGTON, NC 28405-3158
(910) 667-7000
(910) 815-5850
Mailing address
PO BOX 936857, ATLANTA, GA 31193-6857
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
—
—
Other
Enumeration date
05/13/2025
Last updated
05/13/2025
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