Organization
NOVANT HEALTH MEDICAL GROUP, LLC
Active
Other names
Novant Health Internal Medicine Gateway
Organization subpart
No
Provider details
NPI number
Authorized official
LEEA JEANINE WALTON (RCS MANAGER)
(704) 316-6081
Entity
Organization
Contact information
Practice address
157 PROFESSIONAL PARK DR STE A, MOORESVILLE, NC 28117-5606
(704) 662-3967
(704) 662-3975
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Enumeration date
04/25/2024
Last updated
06/04/2024
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