Organization
NOVANT MEDICAL GROUP INC
Active
Organization
NOVANT MEDICAL GROUP INC
Active
Other names
Novant Health Urology Partners
Organization subpart
No
Provider details
NPI number
Authorized official
LEEA JEANINE WALTON (RCS MANAGER)
(704) 316-6081
Entity
Organization
Contact information
Practice address
1456 N HOWE ST, SUITE 201, SOUTHPORT, NC 28461-2754
(910) 721-4150
(910) 721-4159
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
(910) 721-4150
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
—
—
Other
Enumeration date
02/06/2015
Last updated
07/12/2023
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