Organization
NOVANT MEDICAL GROUP INC
Active
Organization
NOVANT MEDICAL GROUP INC
Active
Other names
Novant Health Total Spine Specialists
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GEOFFREY KEITH GARDNER (VP FINANCE)
(704) 544-6920
Entity
Organization
Contact information
Practice address
1450 MATTHEWS TOWNSHIP PARKWAY, SUITE 355, MATTHEWS, NC 28105-4300
(704) 544-6920
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
(704) 384-7840
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
—
—
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
208100000X
Physical Medicine & Rehabilitation Physician
—
—
208VP0000X
Pain Medicine Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1114366994
—
NC
Enumeration date
06/14/2013
Last updated
03/27/2014
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