Organization
NOVANT HEALTH MEDICAL GROUP, LLC
Active
Other names
Novant Health Inpatient Care Specialists, Novant Health Inpatient Care Specialists 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
1901 E 5TH ST, CHARLOTTE, NC 28204-2429
(980) 367-4363
(704) 384-1644
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
(980) 367-4363
(704) 316-2558
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
018F6
BCBS NC
NC
05
—
5904172
—
NC
01
—
CC5118
RAILROAD MEDICARE
NC
05
—
NPB180
—
SC
Enumeration date
08/01/2006
Last updated
08/21/2024
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