Organization
NOVANT HEALTH MEDICAL GROUP, LLC
Active
Parent organization
NOVANT MEDICAL GROUP, INC
Other names
Novant Health Primary Care Partners
Organization subpart
Yes
Provider details
NPI number
Legal business name
NOVANT MEDICAL GROUP, INC
Authorized official
LEEA JEANINE WALTON (RCS MANAGER)
(704) 316-6081
Entity
Organization
Contact information
Practice address
10500 LIGON MILL RD, SUITE 113, WAKE FOREST, NC 27587-4576
(919) 570-5705
(919) 570-5710
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
(919) 570-5705
(919) 570-5710
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
2005-01578
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5914970
—
NC
Enumeration date
05/20/2010
Last updated
07/09/2024
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