Organization
NOVANT MEDICAL GROUP, INC.
Active
Other names
Novant Health Bermuda Run Family Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
SHALA DAVIS (RCS MANAGER)
(704) 316-7845
Entity
Organization
Contact information
Practice address
5380 US HIGHWAY 158 STE 110, ADVANCE, NC 27006-6979
(336) 893-3225
(336) 893-3219
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
01/09/2019
Last updated
01/09/2019
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