Organization
NOVANT MEDICAL GROUP, INC.
Active
Other names
Gaston Family Docs
Organization subpart
No
Provider details
NPI number
Authorized official
DINESH S. PAI (VP OF OPERATIONS)
(704) 384-9104
Entity
Organization
Contact information
Practice address
2290 REMOUNT RD, GASTONIA, NC 28054-4725
(704) 853-3627
(704) 853-3500
Mailing address
2290 REMOUNT RD, GASTONIA, NC 28054-4725
(704) 853-3627
(704) 853-3500
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
363A00000X
Physician Assistant
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
019R8
BCBS OF NC
NC
05
—
5908354
—
NC
Enumeration date
10/24/2007
Last updated
06/08/2008
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