Organization
NOVANT HEALTH MEDICAL GROUP, LLC
Active
Other names
Novant Health Cardiothoracic Surgeons
Organization subpart
No
Provider details
NPI number
Authorized official
LEEA JEANINE WALTON (RCS MANAGER)
(704) 316-6081
Entity
Organization
Contact information
Practice address
4622 COUNTRY CLUB RD, SUITE 180, WINSTON SALEM, NC 27104-3770
(336) 768-9535
(336) 768-4155
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
(704) 384-7680
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
—
—
2086S0129X
Vascular Surgery Physician
—
—
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
—
—
Other
Enumeration date
04/23/2012
Last updated
06/20/2024
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