Organization
NOVANT MEDICAL GROUP, INC.
Active
Other names
Wassel Wound 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
7752 GATEWAY LN, SUITE 100, CONCORD, NC 28027-4418
(704) 316-4950
(704) 316-4951
Mailing address
1900 RANDOLPH RD, SUITE 500, CHARLOTTE, NC 28207-1122
(704) 384-9113
(704) 316-0508
Taxonomy
Speciality
Code
Description
License number
State
2083P0011X
Undersea and Hyperbaric Medicine (Preventive Medicine) Physician
Primary
—
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
019FK
BCBS
NC
05
—
5906340
—
NC
01
—
K999
PARTNERS
NC
Enumeration date
08/18/2006
Last updated
08/18/2008
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