Organization
NOVANT HEALTH MEDICAL GROUP, LLC
Active
Organization
NOVANT HEALTH MEDICAL GROUP, LLC
Active
Other names
Novant Health Dermatology Associates
Organization subpart
No
Provider details
NPI number
Authorized official
LEEA JEANINE WALTON (RCS MANAGER)
(704) 316-6081
Entity
Organization
Contact information
Practice address
1450 MATTHEWS TOWNSHIP PKWY STE 355, MATTHEWS, NC 28105-4300
(704) 384-6020
(704) 384-6025
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
(704) 384-6020
(704) 384-6025
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5906187
—
NC
01
—
71098
BCBS NC
NC
01
—
CC5118
RAILROAD MEDICARE
NC
05
—
NPB227
—
SC
Enumeration date
06/14/2006
Last updated
09/12/2025
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