Organization
NOVANT HEALTH MEDICAL GROUP COASTAL REGION, LLC
Active
Other names
Coastal Family Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
SHALA DAVIS (RCS MANAGER)
(704) 303-7517
Entity
Organization
Contact information
Practice address
2523 DELANEY AVE, WILMINGTON, NC 28403-6003
(910) 763-5522
Mailing address
PO BOX 936857, ATLANTA, GA 31193-6857
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
04/09/2021
Last updated
07/19/2021
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