Organization
NMG AFFILIATE PRACTICE I LLC
Active
Other names
Novant Health Heart and Vascular
Organization subpart
No
Provider details
NPI number
Authorized official
GEOFFREY K GARDNER (VP FINANCE)
(704) 384-7606
Entity
Organization
Contact information
Practice address
110 EAST BLUE RIDGE STREET, STUART, VA 24171
(276) 694-3715
(276) 694-2587
Mailing address
PO BOX 602362, CHARLOTTE, NC 28260-2362
(704) 384-7840
(704) 384-7830
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
—
—
Other
Enumeration date
01/13/2011
Last updated
06/26/2013
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