Organization
NOVANT HEALTH MEDICAL GROUP, LLC
Active
Other names
Novant Health Pine Lake Family Physicians
Organization subpart
No
Provider details
NPI number
Authorized official
LEEA JEANINE WALTON (RCS MANAGER)
(704) 316-6081
Entity
Organization
Contact information
Practice address
7800 STEVENS MILL RD, SUITE 0, MATTHEWS, NC 28104-6111
(704) 316-9090
(704) 316-9095
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
(704) 316-9090
(704) 316-9095
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
05/15/2012
Last updated
07/09/2024
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