Organization
NOVANT MEDICAL GROUP INC
Active
Other names
Novant Health Vascular Diagnostics
Organization subpart
No
Provider details
NPI number
Authorized official
SHALA DAVIS (MANAGER)
(704) 303-7517
Entity
Organization
Contact information
Practice address
1710 KERNERSVILLE MEDICAL PKWY STE 202, KERNERSVILLE, NC 27284-7156
(336) 768-5445
(336) 768-7950
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
(336) 768-5445
(336) 768-7950
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
—
—
2086S0129X
Vascular Surgery Physician
Primary
—
—
Other
Enumeration date
02/13/2013
Last updated
08/17/2021
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