Organization
NOVANT HEALTH MEDICAL GROUP COASTAL REGION, LLC
Active
Other names
Novant Health Cancer Institute
Organization subpart
No
Provider details
NPI number
Authorized official
SHALA DAVIS (ENROLLMENT MANAGER)
(704) 303-7517
Entity
Organization
Contact information
Practice address
75 EMERSON BAY RD STE 104, CAROLINA SHORES, NC 28467-2498
(910) 667-4283
(910) 338-0965
Mailing address
PO BOX 936857, ATLANTA, GA 31193-6857
(910) 667-4283
(910) 338-0965
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
—
—
207VX0201X
Gynecologic Oncology Physician
—
—
Other
Enumeration date
09/07/2021
Last updated
09/18/2025
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