Organization
NOVANT HEALTH MEDICAL GROUP, LLC
Active
Other names
Novant Health Elizabeth Pediatrics
Organization subpart
No
Provider details
NPI number
Authorized official
LEEA JEANINE WALTON (RCS MANAGER)
(704) 316-6081
Entity
Organization
Contact information
Practice address
2630 E 7TH ST, SUITE 101, CHARLOTTE, NC 28204-4319
(704) 384-1000
(704) 384-1012
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
(704) 384-1000
(704) 384-1012
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0272T
BCBS-NC
NC
05
—
890272T
—
NC
05
—
NPA887
—
SC
Enumeration date
05/25/2006
Last updated
06/20/2024
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