Organization
NOVANT MEDICAL GROUP, INC
Active
Other names
Novant Health Headache & Sleep Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
SHALA DAVIS (RCS MANAGER)
(704) 303-7517
Entity
Organization
Contact information
Practice address
1471 JAG BRANCH BLVD STE 105, KERNERSVILLE, NC 27284-6956
(336) 765-5553
(336) 765-5359
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
(336) 765-5553
(336) 765-5359
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
—
—
Other
Enumeration date
07/03/2012
Last updated
06/09/2022
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