Organization
NOVANT HEALTH MEDICAL GROUP, LLC
Active
Other names
Novant Health Lakeside Primary Care
Organization subpart
No
Provider details
NPI number
Authorized official
LEEA JEANINE WALTON (RCS MANAGER)
(704) 316-6081
Entity
Organization
Contact information
Practice address
5325 VINNING ST NW, SUITE 101, CONCORD, NC 28027-2956
(704) 316-1040
(704) 316-1041
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
(704) 316-1040
(704) 316-1041
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NC
207R00000X
Internal Medicine Physician
—
NC
Other
Enumeration date
06/19/2008
Last updated
07/09/2024
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