Organization
NOVANT HEALTH MEDICAL GROUP, LLC
Active
Other names
Novant Health First Charlotte Physicians Matthews
Organization subpart
No
Provider details
NPI number
Authorized official
LEEA JEANINE WALTON (RCS MANAGER)
(704) 316-6081
Entity
Organization
Contact information
Practice address
1401 MATTHEWS TOWNSHIP PKWY, SUITE 200, MATTHEWS, NC 28105-5403
(704) 384-6901
(704) 384-6902
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
(704) 384-6901
(704) 384-6902
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
011JC
BCBS
NC
05
—
89011JC
—
NC
01
—
CC5118
RAILROAD MEDICARE
NC
Enumeration date
05/25/2006
Last updated
07/09/2024
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