Organization
NOVANT HEALTH MEDICAL GROUP, LLC
Active
Other names
Novant Health Sleep Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
LEEA JEANINE WALTON (RCS MANAGER)
(704) 316-6081
Entity
Organization
Contact information
Practice address
14135 BALLANTYNE CORPORATE PL STE 160, CHARLOTTE, NC 28277-4221
(704) 316-5000
(704) 316-5010
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
(704) 316-5000
(704) 316-5010
Taxonomy
Speciality
Code
Description
License number
State
2084S0012X
Sleep Medicine (Psychiatry & Neurology) Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
019J7
BCBS NC
NC
05
—
1265622377
—
NC
Enumeration date
07/26/2007
Last updated
06/19/2024
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