Organization
NOVANT HEALTH MEDICAL GROUP, LLC
Active
Other names
Novant Health Pediatric Sports Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
LEEA JEANINE WALTON (EDI MANAGER)
(704) 316-6081
Entity
Organization
Contact information
Practice address
201 QUEENS RD, CHARLOTTE, NC 28204
(704) 316-1070
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
Taxonomy
Speciality
Code
Description
License number
State
2080S0010X
Pediatric Sports Medicine Physician
Primary
—
—
Other
Enumeration date
08/16/2017
Last updated
07/11/2024
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