Organization
NOVANT MEDICAL GROUP, INC.
Active
Other names
The Medical Group
Organization subpart
No
Provider details
NPI number
Authorized official
DINESH S PAI (VP OF OPERATIONS)
(704) 384-9104
Entity
Organization
Contact information
Practice address
701 MEDICAL PARK DR, SUITE 301, HARTSVILLE, SC 29550-4777
(843) 878-1004
(843) 332-9229
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
(843) 878-1004
(843) 332-9229
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
207R00000X
Internal Medicine Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GP4931
—
SC
Enumeration date
07/30/2008
Last updated
12/22/2008
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