Organization
NOVANT MEDICAL GROUP INC
Active
Parent organization
NOVANT MEDICAL GROUP, INC
Other names
Novant Health Granite Quarry Internal Medicine & Pediatrics
Organization subpart
Yes
Provider details
NPI number
Legal business name
NOVANT MEDICAL GROUP, INC
Authorized official
LEEA JEANINE WALTON (RCS MANAGER)
(704) 316-6081
Entity
Organization
Contact information
Practice address
111 S SALISBURY GQ AVE, SALISBURY, NC 28146-8150
(704) 279-1679
(704) 279-1677
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
(704) 279-1679
(704) 279-1677
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
208000000X
Pediatrics Physician
—
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5913612
—
NC
Enumeration date
10/28/2009
Last updated
07/10/2023
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