Organization
NOVANT MEDICAL GROUP, INC.
Active
Other names
Rocky River Family Physicians
Organization subpart
No
Provider details
NPI number
Authorized official
DINESH S PAI (VP OF OPERATIONS)
(704) 384-9104
Entity
Organization
Contact information
Practice address
602 S SUTHERLAND AVE, MONROE, NC 28112-5063
(704) 384-4820
(704) 384-8425
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
(704) 384-7840
(704) 384-7830
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
017F7
BCBS
NC
05
—
5901677
—
NC
Enumeration date
08/04/2005
Last updated
06/09/2008
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