Organization
NOVANT HEALTH MEDICAL GROUP COASTAL REGION, LLC
Active
Organization
NOVANT HEALTH MEDICAL GROUP COASTAL REGION, LLC
Active
Other names
Novant Health Urology- Autumn Hall
Organization subpart
No
Provider details
NPI number
Authorized official
LEEA JEANINE WALTON (MANAGER)
(336) 515-7085
Entity
Organization
Contact information
Practice address
510 CAROLINA BAY DR STE 110, WILMINGTON, NC 28403-2046
(910) 662-8765
Mailing address
PO BOX 936857, ATLANTA, GA 31193-6857
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
—
—
Other
Enumeration date
08/19/2026
Last updated
08/19/2026
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