Organization
NOVANT MEDICAL GROUP INC
Active
Other names
Novant Health Psychiatric Associates
Organization subpart
No
Provider details
NPI number
Authorized official
GEOFFREY K. GARDNER (VP OF FINANCE)
(704) 384-1246
Entity
Organization
Contact information
Practice address
16525 HOLLY CREST LN, SUITE 210, HUNTERSVILLE, NC 28078-4912
(704) 384-1246
(704) 384-1249
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
(704) 384-1246
(704) 384-1249
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
—
—
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5915179
—
NC
Enumeration date
08/04/2010
Last updated
07/05/2013
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