Organization
NOVANT MEDICAL GROUP INC
Active
Other names
Novant Health Colon and Rectal Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
GEOFFREY K. GARDNER (VP OF FINANCE)
(336) 765-5221
Entity
Organization
Contact information
Practice address
7126 VILLAGE MEDICAL CIR, CLEMMONS, NC 27012-8004
(336) 765-5221
(336) 765-0430
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
(704) 384-7840
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
—
—
208C00000X
Colon & Rectal Surgery Physician
Primary
—
—
Other
Enumeration date
05/30/2014
Last updated
03/11/2015
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