Organization
NOVANT HEALTH MEDICAL GROUP LLC
Active
Other names
Novant Health WomanCare
Organization subpart
No
Provider details
NPI number
Authorized official
LEEA JEANINE WALTON (RCS MANAGER)
(704) 316-6081
Entity
Organization
Contact information
Practice address
1730 KERNERSVILLE MEDICAL PARKWAY, SUITE 104, KERNERSVILLE, NC 27284-7198
(336) 765-5470
(336) 499-5428
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
(336) 765-5470
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1194113662
—
NC
01
—
2319872
MEDICARE
NC
Enumeration date
01/06/2015
Last updated
06/21/2024
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