Organization
NOVANT MEDICAL GROUP INC
Active
Other names
Brunswick Primary Care
Organization subpart
No
Provider details
NPI number
Authorized official
DINESH S. PAI (VP OF OPERATIONS)
(704) 384-9104
Entity
Organization
Contact information
Practice address
18 DOCTORS CIR, SUITE 2, SUPPLY, NC 28462-4089
(910) 755-6802
(910) 755-6804
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
(910) 755-6802
(910) 755-6804
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
207R00000X
Internal Medicine Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5903336
—
NC
Enumeration date
05/03/2006
Last updated
06/02/2009
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