Organization
NOVANT MEDICAL GROUP, INC.
Active
Other names
Novant Health Family Medicine Associates
Organization subpart
No
Provider details
NPI number
Authorized official
GEOFFREY GARDNER (VP OF OPERATIONS)
(704) 384-9094
Entity
Organization
Contact information
Practice address
207 CHURCH ST, CLOVER, SC 29710-1008
(803) 222-3063
(803) 222-3064
Mailing address
PO BOX 602362, CHARLOTTE, NC 28260-2362
(704) 384-7840
(704) 384-7830
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GP4331
—
SC
Enumeration date
05/10/2006
Last updated
06/27/2013
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