Organization
NOVANT MEDICAL GROUP, INC.
Active
Other names
Mid Carolina Cardiology
Organization subpart
No
Provider details
NPI number
Authorized official
GEOFFREY GARDNER (VP OF OPERATIONS)
(704) 384-9094
Entity
Organization
Contact information
Practice address
10030 GILEAD RD, STE 201, HUNTERSVILLE, NC 28078-7545
(704) 887-4530
(704) 887-4531
Mailing address
PO BOX 602362, CHARLOTTE, NC 28260-2362
(704) 384-7840
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
019H6
BCBS-NC
NC
05
—
5908575
—
NC
01
—
DG5273
RAILROAD MEDICARE
NC
05
—
NPA577
—
SC
Enumeration date
07/29/2005
Last updated
07/19/2011
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