Organization
NOVANT MEDICAL GROUP INC
Active
Other names
Novant Health Lakeside Family Physicians
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GEOFFREY K GARDNER (VP FINANCE)
(704) 384-9094
Entity
Organization
Contact information
Practice address
19485 OLD JETTON RD, SUITE 100, CORNELIUS, NC 28031-6582
(704) 384-1775
(704) 384-1776
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
—
207Q00000X
Family Medicine Physician
—
—
Other
Enumeration date
09/14/2012
Last updated
02/27/2017
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