Organization
NOVANT MEDICAL GROUP, INC.
Active
Organization
NOVANT MEDICAL GROUP, INC.
Active
Other names
First Charlotte Physicians Randolph
Organization subpart
No
Provider details
NPI number
Authorized official
DINESH S PAI (VP OF OPERATIONS)
(704) 384-9104
Entity
Organization
Contact information
Practice address
1918 RANDOLPH RD, SUITE 350, CHARLOTTE, NC 28207-1100
(704) 384-1750
(704) 384-1748
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
(704) 384-7840
(704) 384-7830
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0272V
BCBS
NC
05
—
890272V
—
NC
01
—
CC5118
RAILROAD MEDICARE
NC
05
—
NPA902
—
SC
Enumeration date
05/25/2006
Last updated
08/15/2008
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