Organization
NOVANT HEALTH MEDICAL GROUP, LLC
Active
Other names
Novant Health Colon & Rectal Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
LEEA JEANINE WALTON (RCS MANAGER)
(704) 316-6081
Entity
Organization
Contact information
Practice address
7210 VILLAGE MEDICAL CIR STE 310, CLEMMONS, NC 27012-8041
(336) 277-4075
(336) 277-4070
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
(336) 277-4075
(336) 277-4070
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
—
—
208C00000X
Colon & Rectal Surgery Physician
Primary
—
—
Other
Enumeration date
02/08/2013
Last updated
03/20/2025
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