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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