Organization
NOVANT HEALTH MEDICAL GROUP LLC
Active
Other names
Novant Health Brunswick Ob/Gyn & Midwifery, Novant Health OB/GYN
Organization subpart
No
Provider details
NPI number
Authorized official
LEEA JEANINE WALTON (EDI MANAGER)
(704) 316-6081
Entity
Organization
Contact information
Practice address
584 HOSPITAL DR NE UNIT B, BOLIVIA, NC 28422-0020
(910) 721-4050
(910) 721-4051
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
(910) 721-4050
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5903335
—
NC
Enumeration date
05/05/2006
Last updated
03/12/2025
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