Organization
NOVANT HEALTH MEDICAL GROUP, LLC
Active
Other names
Novant Health Sleep Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
LEEA JEANINE WALTON (RCS MANAGER)
(704) 316-6081
Entity
Organization
Contact information
Practice address
6909 PROSPERITY CHURCH RD, HUNTERSVILLE, NC 28078-6698
(704) 316-2050
(704) 316-2051
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
(704) 316-2050
(704) 316-2051
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
—
NC
207RP1001X
Pulmonary Disease Physician
—
NC
207RS0012X
Sleep Medicine (Internal Medicine) Physician
Primary
—
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
017VP
BCBS NC
NC
05
—
1346264835
—
NC
05
—
NPB162
—
SC
Enumeration date
07/27/2006
Last updated
06/20/2024
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