Organization
NOVANT HEALTH MEDICAL GROUP, LLC
Active
Other names
Novant Health Dilworth Pediatrics
Organization subpart
No
Provider details
NPI number
Authorized official
LEEA JEANINE WALTON (RCS MANAGER)
(704) 316-6081
Entity
Organization
Contact information
Practice address
1315 EAST BLVD, SUITE 280, CHARLOTTE, NC 28203-5793
(704) 384-1866
(704) 384-1867
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
(704) 384-1866
(704) 384-1867
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
015UU
BCBS-NC
NC
05
—
89015UU
—
NC
05
—
NPB261
—
SC
Enumeration date
05/23/2006
Last updated
06/20/2024
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
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