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Organization

NOVANT MEDICAL GROUP INC

Active
Other names
Novant Health Pediatric Pulmonology
Organization subpart
No

Provider details

NPI number
Authorized official
SHALA DAVIS (ENROLLMENT MANAGER)
(704) 316-7845
Entity
Organization

Contact information

Practice address
5370 RIDGE RD, CHARLOTTE, NC 28269-2298
(704) 316-5280
(704) 316-5852
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
(704) 316-5280
(704) 316-5852

Taxonomy

Speciality
Code
Description
License number
State
2080P0214X
Pediatric Pulmonology Physician
Primary

Other

Enumeration date
05/23/2019
Last updated
05/23/2019
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