Organization
NOVANT MEDICAL GROUP INC
Active
Other names
Novant Health Pediatric Neurology
Organization subpart
No
Provider details
NPI number
Authorized official
SHALA DAVIS (RCS MANAGER)
(704) 303-7517
Entity
Organization
Contact information
Practice address
311 CODDLE MARKET DR NW, STE 200, CONCORD, NC 28027-2432
(704) 384-1390
(704) 384-1063
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
Taxonomy
Speciality
Code
Description
License number
State
2084N0402X
Neurology with Special Qualifications in Child Neurology Physician
Primary
—
—
Other
Enumeration date
02/08/2019
Last updated
08/16/2021
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