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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
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