Organization
NOVANT MEDICAL GROUP INC
Active
Other names
Novant Health Nutrition Solutions
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GEOFFREY K GARDNER (VP FINANCE, NMG)
(336) 718-6770
Entity
Organization
Contact information
Practice address
4130 CLEMMONS RD, CLEMMONS, NC 27012-7520
(336) 277-1890
(336) 277-1889
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
(336) 277-1890
(336) 277-1889
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
207RC0000X
Cardiovascular Disease Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1295092856
—
NC
Enumeration date
04/19/2012
Last updated
12/18/2015
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