Organization
NOVANT MEDICAL GROUP, INC.
Active
Other names
Sunset Beach Family Medical
Organization subpart
No
Provider details
NPI number
Authorized official
DINESH S. PAI (VP OF OPERATIONS)
(704) 384-9104
Entity
Organization
Contact information
Practice address
710 SUNSET BLVD N, SUITE B, SUNSET BEACH, NC 28468-4345
(910) 575-0006
(910) 575-3972
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
(704) 384-9679
(704) 316-0508
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
018PA
BCBS NC
NC
05
—
5905835
—
NC
Enumeration date
11/14/2006
Last updated
02/11/2009
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