Organization
NOVANT HEALTH MEDICAL GROUP, LLC
Active
Other names
Novant Health South Park Family Physicians
Organization subpart
No
Provider details
NPI number
Authorized official
LEEA JEANINE WALTON (RCS MANAGER)
(704) 316-6081
Entity
Organization
Contact information
Practice address
6324 FAIRVIEW ROAD, SUITE 201, CHARLOTTE, NC 28210-4278
(704) 384-0588
(704) 384-0580
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
(704) 384-0588
(704) 384-0580
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
017X3
BCBS NC
NC
05
—
5903451
—
NC
01
—
CC5118
RAILROAD MEDICARE
NC
05
—
NPB165
—
SC
Enumeration date
06/30/2006
Last updated
07/09/2024
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us