Organization
NOVANT MEDICAL GROUP, INC.
Active
Other names
Novant Health Parker Internal Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
GEOFFERY GARDNER (VP FINANCE)
(704) 384-7283
Entity
Organization
Contact information
Practice address
330 BILLINGSLEY RD, SUITE 101, CHARLOTTE, NC 28211-5020
(704) 384-1605
(704) 384-1610
Mailing address
PO BOX 602362, CHARLOTTE, NC 28260-2362
(704) 384-1605
(704) 384-1610
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
015YP
BCBS NC
NC
05
—
89015YP
—
NC
Enumeration date
06/07/2006
Last updated
07/31/2013
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