Organization
NOVANT HEALTH MEDICAL GROUP, LLC
Active
Other names
Novant Health Oceanside Family Medicine & Convenient Care
Organization subpart
No
Provider details
NPI number
Authorized official
LEEA JEANINE WALTON (RCS MANAGER)
(704) 316-6081
Entity
Organization
Contact information
Practice address
5145 SELLERS RD, SUITE A, SHALLOTTE, NC 28470-3405
(910) 754-4441
(910) 754-5307
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
(910) 754-4441
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
018N9
BCBS NC
NC
05
—
5905786
—
NC
Enumeration date
11/17/2006
Last updated
07/09/2024
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