Organization
NMG AFFILIATE PRACTICE I, LLC
Active
Other names
Novant Health Care Connections Senior Care
Organization subpart
No
Provider details
NPI number
Authorized official
SHALA DAVIS (RCS MANAGER)
(704) 316-7845
Entity
Organization
Contact information
Practice address
190 MORAVIAN WAY DR, WINSTON SALEM, NC 27106-3216
(336) 856-0701
(336) 856-2804
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
05/01/2019
Last updated
05/01/2019
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