Organization
NOVANT HEALTH MEDICAL GROUP, LLC
Active
Other names
Novant Health Matthews Family Physicians
Organization subpart
No
Provider details
NPI number
Authorized official
LEEA JEANINE WALTON (RCS MANAGER)
(704) 316-6081
Entity
Organization
Contact information
Practice address
1450 MATTHEWS TOWNSHIP PKWY, SUITE 450, MATTHEWS, NC 28105-5343
(704) 384-8480
(704) 384-8481
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
(704) 384-8480
(704) 384-8481
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
011CA
BCBS-NC
NC
05
—
89011CA
—
NC
05
—
NPA898
—
SC
Enumeration date
06/10/2006
Last updated
07/09/2024
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