Organization
NOVANT MEDICAL GROUP, INC.
Active
Other names
McKee Internal Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
GEOFFREY GARDNER (VP OF OPERATIONS)
70438499094
Entity
Organization
Contact information
Practice address
3330 SISKEY PARKWAY, MATTHEWS, NC 28105
(704) 316-2127
(704) 316-2136
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
(704) 384-7840
(704) 384-7830
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
019U2
BCBS-NC
NC
05
—
5908614
—
NC
05
—
NPB258
—
SC
Enumeration date
12/06/2007
Last updated
08/05/2011
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