Organization
NOVANT HEALTH MEDICAL GROUP COASTAL REGION, LLC
Active
Other names
NOVANT HEALTH MEDICAL GROUP COASTAL REGION, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
SHALA DAVIS (ENROLLMENT COORDINATOR)
(704) 316-7845
Entity
Organization
Contact information
Practice address
1520 PHYSICIANS DR, WILMINGTON, NC 28401-7356
(910) 662-8300
Mailing address
PO BOX 936857, ATLANTA, GA 31193-6857
(910) 662-8300
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
—
—
Other
Enumeration date
04/09/2021
Last updated
04/09/2021
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