Organization
NOVANT MEDICAL GROUP, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHALA DAVIS (RCS MANAGER)
(704) 316-7845
Entity
Organization
Contact information
Practice address
201 QUEENS RD, CHARLOTTE, NC 28204-3217
(704) 316-5820
(704) 316-5821
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Enumeration date
06/25/2019
Last updated
06/25/2019
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