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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