Organization
NOVANT HEALTH MEDICAL GROUP COASTAL REGION, LLC
Active
Other names
Novant Health UNC Children's
Organization subpart
No
Provider details
NPI number
Authorized official
LEEA JEANINE WALTON (ENROLLMENT MANAGER)
(336) 515-7085
Entity
Organization
Contact information
Practice address
2131 S 17TH ST, WILMINGTON, NC 28401-7407
(910) 662-9300
Mailing address
PO BOX 936857, ATLANTA, GA 31193-6857
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
2080P0202X
Pediatric Cardiology Physician
—
—
2088P0231X
Pediatric Urology Physician
—
—
Other
Enumeration date
04/13/2021
Last updated
10/22/2024
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