Organization
NOVANT HEALTH MEDICAL GROUP, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LEEA JEANINE WALTON (RCS MANAGER)
(704) 316-6081
Entity
Organization
Contact information
Practice address
11840 SOUTHMORE DR STE 201, CHARLOTTE, NC 28277-0785
(704) 384-9900
(704) 384-9919
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
(704) 384-9900
(704) 384-9919
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
—
—
207RP1001X
Pulmonary Disease Physician
Primary
—
—
207RS0012X
Sleep Medicine (Internal Medicine) Physician
—
—
Other
Enumeration date
03/04/2013
Last updated
06/19/2024
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