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Organization

NOVANT MEDICAL GROUP, INC.

Active
Other names
Novant Health Southeast OB/GYN
Organization subpart
No

Provider details

NPI number
Authorized official
GEOFFREY K GARDNER (VP OF FINANCE)
(704) 321-1077
Entity
Organization

Contact information

Practice address
1450 MATTHEWS TOWNSHIP PKWY, STE 300, MATTHEWS, NC 28105-5332
(704) 321-1077
(704) 321-1086
Mailing address
PO BOX 602362, CHARLOTTE, NC 28260-2362
(704) 321-1077
(704) 321-1086

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
011V2
BCBS NC
NC
05
5907956
NC
Enumeration date
03/01/2007
Last updated
06/26/2013
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