Organization
NOVANT MEDICAL GROUP, INC.
Active
Parent organization
NOVANT MEDICAL GROUP, INC.
Other names
Novant Health Diabetes & Nutrition
Organization subpart
Yes
Provider details
NPI number
Legal business name
NOVANT MEDICAL GROUP, INC.
Authorized official
SHALA DAVIS (MANAGED CARE MANAGER)
(704) 303-7517
Entity
Organization
Contact information
Practice address
1710 KERNERSVILLE MEDICAL PKWY STE 210, KERNERSVILLE, NC 27284-7157
(336) 718-6770
(336) 277-1889
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Enumeration date
11/19/2019
Last updated
08/17/2021
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