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Organization

NOVANT MEDICAL GROUP INC

Active
Other names
Novant Health Developmental & Behavioral Pediatrics
Organization subpart
No

Provider details

NPI number
Authorized official
SHALA DAVIS (ENROLLMENT MANAGER)
(704) 316-7845
Entity
Organization

Contact information

Practice address
17810 STATESVILLE RD STE 311, CORNELIUS, NC 28031-8149
(704) 384-0567
(704) 384-0568
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
(704) 384-0567
(704) 384-0568

Taxonomy

Speciality
Code
Description
License number
State
2080P0006X
Developmental - Behavioral Pediatrics Physician
Primary

Other

Enumeration date
06/14/2019
Last updated
06/14/2019
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