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Organization

NOVANT HEALTH MEDICAL GROUP, LLC

Active
Other names
Novant Health First Charlotte Physicians Elizabeth, Novant Health First Charlotte Physicians EpiCentre
Organization subpart
No

Provider details

NPI number
Authorized official
LEEA JEANINE WALTON (EDI MANAGER)
(704) 316-6081
Entity
Organization

Contact information

Practice address
1942 E 7TH ST STE 200, CHARLOTTE, NC 28204-2418
(704) 384-7085
(704) 384-7089
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
(704) 384-7085
(704) 384-7089

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
011JG
BCBS-NC
NC
05
89011JG
NC
01
CC5118
RAILROAD MEDICARE
NC
Enumeration date
05/16/2006
Last updated
07/09/2024
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