Organization
NOVANT HEALTH MEDICAL GROUP COASTAL REGION, LLC
Active
Other names
Novant Health Urology
Organization subpart
No
Provider details
NPI number
Authorized official
LEEA JEANINE WALTON (ENROLLMENT MANAGER)
(336) 515-7085
Entity
Organization
Contact information
Practice address
1099 MEDICAL CENTER DR STE 101, WILMINGTON, NC 28401-7367
(910) 254-9995
(910) 254-9996
Mailing address
PO BOX 936857, ATLANTA, GA 31193-6857
(910) 254-9995
(910) 254-9996
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
—
—
Other
Enumeration date
05/13/2024
Last updated
06/13/2024
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