Organization
NOVANT MEDICAL GROUP INC
Active
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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