Organization
NOVANT MEDICAL GROUP, INC.
Active
Other names
Regional Surgical Associates
Organization subpart
No
Provider details
NPI number
Authorized official
GEOFFREY GARDNER (VP OF OPERATIONS)
(704) 384-9094
Entity
Organization
Contact information
Practice address
4301 BEN FRANKLIN BLVD, DURHAM, NC 27704-2145
(919) 479-4400
(919) 479-4420
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
(704) 384-7840
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
020C3
BCBS NC
NC
05
—
5905998
—
NC
Enumeration date
02/05/2007
Last updated
07/20/2011
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