Organization
NOVANT MEDICAL GROUP, INC.
Active
Other names
Novant Health Randolph OB/GYN
Organization subpart
No
Provider details
NPI number
Authorized official
GEOFFREY K. GARDNER (VP OF FINANCE)
(704) 384-9094
Entity
Organization
Contact information
Practice address
2711 RANDOLPH RD, SUITE 512, CHARLOTTE, NC 28207-2027
(704) 333-4104
(704) 358-4544
Mailing address
PO BOX 602362, CHARLOTTE, NC 28260-2362
(704) 333-4104
(704) 358-4544
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
—
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
011V1
BCBS
NC
Enumeration date
06/11/2006
Last updated
06/21/2013
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