Organization
NOVANT MEDICAL GROUP, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GEOFFREY GARDNER (VP FINANCE)
(704) 384-7283
Entity
Organization
Contact information
Practice address
269 GILLMAN RD STE 200A, DENVER, NC 28037-7919
(704) 316-1150
(704) 316-1151
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
(704) 316-1150
(704) 316-1151
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
—
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
018X4
BCBS
NC
05
—
5905988
—
NC
01
—
CC5118
RAILROAD MEDICARE
NC
Enumeration date
01/25/2007
Last updated
10/12/2017
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