Organization
NOVANT HEALTH MEDICAL GROUP, LLC
Active
Other names
Novant Health Heart and Vascular Institute
Organization subpart
No
Provider details
NPI number
Authorized official
LEEA JEANINE WALTON (RCS MANAGER)
(704) 316-6081
Entity
Organization
Contact information
Practice address
401 MOCKSVILLE AVE FL 2, SALISBURY, NC 28144-2735
(704) 633-9620
(704) 633-7504
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
(704) 633-9620
(704) 633-7504
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
—
—
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
019H6
BCBS-NC
NC
05
—
5908575
—
NC
01
—
DG5273
RAILROAD MEDICARE
NC
05
—
NPA577
—
SC
Enumeration date
07/26/2005
Last updated
06/20/2024
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