Organization
NOVANT MEDICAL GROUP, INC.
Active
Other names
Novant Anesthesia Associates of Brunswick
Organization subpart
No
Provider details
NPI number
Authorized official
GEOFFREY K GARDNER (VP OF FINANCE)
(704) 384-9094
Entity
Organization
Contact information
Practice address
240 HOSPITAL DR NE, BOLIVIA, NC 28422-8346
(910) 755-1099
(704) 755-1173
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
(704) 384-7840
(704) 384-7830
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5908814
—
NC
Enumeration date
10/24/2007
Last updated
06/27/2013
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