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Organization

NOVANT MEDICAL GROUP INC

Active
Other names
Novant Health Triad Surgical Associates
Organization subpart
No

Provider details

NPI number
Authorized official
MR. GEOFFREY K GARDNER (VP FINANCE)
(336) 765-0155
Entity
Organization

Contact information

Practice address
1900 S HAWTHORNE RD, SUITE 480, WINSTON SALEM, NC 27103-3913
(336) 765-0155
(336) 765-5494
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
(704) 384-7840

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1376976043
NC
Enumeration date
08/16/2013
Last updated
05/01/2014
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