Organization
NOVANT MEDICAL GROUP, INC
Active
Organization
NOVANT MEDICAL GROUP, INC
Active
Other names
Novant Health Dermatology, Novant Medical Group, Inc.
Organization subpart
No
Provider details
NPI number
Authorized official
SHALA DAVIS (ENROLLMENT COORDINATOR)
(704) 303-7517
Entity
Organization
Contact information
Practice address
15033 BALLANCROFT PKWY, CHARLOTTE, NC 28277-4958
(704) 384-9437
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
(704) 384-9437
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
Other
Enumeration date
12/09/2021
Last updated
02/16/2022
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