Organization
NOVANT HEALTH MEDICAL GROUP, LLC
Active
Other names
Novant Health Psychiatric Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
LEEA JEANINE WALTON (RCS MANAGER)
(704) 316-6081
Entity
Organization
Contact information
Practice address
612 MOCKSVILLE AVE, SALISBURY, NC 28144-2732
(704) 210-5061
(704) 210-5337
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
(704) 210-5061
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5915339
—
NC
Enumeration date
07/28/2010
Last updated
06/20/2024
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