Organization
NOVANT HEALTH MEDICAL GROUP LLC
Active
Other names
Novant Health Rankin OB/GYN
Organization subpart
No
Provider details
NPI number
Authorized official
LEEA JEANINE WALTON (RCS MANAGER)
(704) 316-6081
Entity
Organization
Contact information
Practice address
1918 RANDOLPH RD, SUITE 670, CHARLOTTE, NC 28207-1100
(704) 384-1620
(704) 384-1626
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
(704) 384-1620
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
—
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0275W
BCBS NC
NC
05
—
890275W
—
NC
01
—
CC5118
RAILROAD MEDICARE
NC
05
—
NPA882
—
SC
Enumeration date
06/07/2006
Last updated
06/21/2024
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