Organization
NOVANT HEALTH MEDICAL GROUP, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LEEA JEANINE WALTON (RCS MANAGER)
(704) 316-6081
Entity
Organization
Contact information
Practice address
1965 S US 29 HWY, CHINA GROVE, NC 28023-5684
(704) 855-8338
(704) 855-8339
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
(704) 855-8338
(704) 855-8339
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5914156
—
NC
Enumeration date
03/31/2010
Last updated
07/09/2024
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