Organization
NOVANT HEALTH MEDICAL GROUP, LLC
Active
Other names
Novant Health Urogynecology
Organization subpart
No
Provider details
NPI number
Authorized official
LEEA JEANINE WALTON (RCS MANAGER)
(704) 316-6081
Entity
Organization
Contact information
Practice address
6324 FAIRVIEW RD, STE 390, CHARLOTTE, NC 28210-4173
(704) 316-1120
(704) 316-1121
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
(704) 316-1120
(704) 316-1121
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
—
—
207VF0040X
Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1447414925
—
NC
Enumeration date
07/15/2008
Last updated
07/16/2024
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