Organization
NOVANT HEALTH MEDICAL GROUP, LLC
Active
Other names
Novant Health Family Medicine Liberty Park
Organization subpart
No
Provider details
NPI number
Authorized official
LEEA JEANINE WALTON (RCS MANAGER)
(704) 316-6081
Entity
Organization
Contact information
Practice address
417 E STATESVILLE AVE, MOORESVILLE, NC 28115-2590
(704) 663-3063
(704) 663-4873
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
04/24/2024
Last updated
05/02/2024
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