Organization
NOVANT HEALTH MEDICAL GROUP COASTAL REGION, LLC
Active
Organization
NOVANT HEALTH MEDICAL GROUP COASTAL REGION, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHALA DAVIS (RCS MANAGER)
(704) 316-7845
Entity
Organization
Contact information
Practice address
1814 NEW HANOVER MEDICAL PARK DR, WILMINGTON, NC 28403-5350
(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
04/13/2021
Last updated
04/13/2021
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