Organization
NOVANT MEDICAL GROUP, INC.
Active
Other names
Novant Health Walker Pediatrics
Organization subpart
No
Provider details
NPI number
Authorized official
GEOFFREY K GARDNER (VP OF FINANCE)
(704) 384-1056
Entity
Organization
Contact information
Practice address
1918 RANDOLPH RD, SUITE 700, CHARLOTTE, NC 28207-1100
(704) 384-1056
(704) 384-1046
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
(704) 384-1056
(704) 384-1046
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
018MF
BCBS NC
NC
05
—
5905369
—
NC
05
—
NPB213
—
SC
Enumeration date
10/25/2006
Last updated
03/06/2017
Update your record
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