Organization
NOVANT HEALTH MEDICAL GROUP COASTAL REGION, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHALA DAVIS (RCS MANAGER)
(704) 316-7845
Entity
Organization
Contact information
Practice address
2259 S 17TH ST, WILMINGTON, NC 28401-7542
(910) 662-9300
Mailing address
PO BOX 936857, ATLANTA, GA 31193-6857
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
—
Other
Enumeration date
04/09/2021
Last updated
04/09/2021
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