Organization
NOVANT MEDICAL GROUP, INC
Active
Other names
Presbyterian Bariatric&General Surgery
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GEOFFREY GARDNER (VP FINANCE)
(704) 384-9094
Entity
Organization
Contact information
Practice address
15825 JOHN J DELANEY DR, SUITE 220, CHARLOTTE, NC 28277-3147
(704) 316-7740
(704) 316-7745
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
(704) 316-7740
(704) 316-7745
Taxonomy
Speciality
Code
Description
License number
State
207RB0002X
Obesity Medicine (Internal Medicine) Physician
—
—
208600000X
Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5917054
—
NC
Enumeration date
03/14/2011
Last updated
07/05/2013
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