Organization
NOVANT HEALTH MEDICAL GROUP, LLC
Active
Other names
Novant Health Carmel OB/GYN
Organization subpart
No
Provider details
NPI number
Authorized official
LEEA JEANINE WALTON (RCS MANAGER)
(704) 316-6081
Entity
Organization
Contact information
Practice address
5933 BLAKENEY PARK DR, SUITE 100, CHARLOTTE, NC 28277-5713
(704) 316-2021
(704) 316-2025
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
(704) 384-7840
(704) 384-7830
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
017TK
BCBS-NC
NC
05
—
5903032
—
NC
01
—
CC5118
RAILROAD MEDICARE
NC
05
—
NPB177
—
SC
Enumeration date
04/09/2006
Last updated
06/20/2024
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