Organization
NOVANT HEALTH MEDICAL GROUP, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LEEA JEANINE WALTON (MANAGER)
(336) 515-7085
Entity
Organization
Contact information
Practice address
502 6TH BAXTER XING, FORT MILL, SC 29708-6596
(704) 377-5675
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
—
—
Other
Enumeration date
09/18/2025
Last updated
09/18/2025
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