Organization
NOVANT MEDICAL GROUP, INC.
Active
Other names
Heart Specialists of Brunswick
Organization subpart
No
Provider details
NPI number
Authorized official
DINESH S PAI (VP OF OPERATIONS)
(704) 384-9104
Entity
Organization
Contact information
Practice address
1029 N HOWE ST, SUITE 100B, SOUTHPORT, NC 28461-3039
(910) 457-9081
(910) 457-9083
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
(704) 384-7840
(704) 384-7830
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
—
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
017YN
BCBS
NC
05
—
5903444
—
NC
Enumeration date
05/23/2006
Last updated
06/08/2008
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