Organization
NOVANT HEALTH MEDICAL GROUP, LLC
Active
Other names
Novant Health Acute Care Surgeons
Organization subpart
No
Provider details
NPI number
Authorized official
LEEA JEANINE WALTON (RCS MANAGER)
(704) 316-6081
Entity
Organization
Contact information
Practice address
3333 SILAS CREEK PKWY, WINSTON SALEM, NC 27103-3013
(336) 718-9080
(336) 718-9085
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
(336) 718-9080
(336) 718-9085
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
16459540030
—
NC
Enumeration date
01/03/2012
Last updated
06/20/2024
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