Organization
NOVANT HEALTH MEDICAL GROUP, LLC
Active
Other names
Novant Health Providence OB/GYN
Organization subpart
No
Provider details
NPI number
Authorized official
LEEA JEANINE WALTON (RCS MANAGER)
(704) 316-6081
Entity
Organization
Contact information
Practice address
6324 FAIRVIEW RD STE 430, CHARLOTTE, NC 28210-4278
(704) 316-3148
(704) 316-3149
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
Taxonomy
Speciality
Code
Description
License number
State
207VX0000X
Obstetrics Physician
Primary
—
—
Other
Enumeration date
02/23/2017
Last updated
06/20/2024
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