Organization
NOVANT HEALTH MEDICAL GROUP COASTAL REGION, LLC
Active
Other names
NHMGCR Physician Specialists
Organization subpart
No
Provider details
NPI number
Authorized official
SHALA DAVIS (RCS MANAGER)
(704) 303-7517
Entity
Organization
Contact information
Practice address
2131 S 17TH ST, WILMINGTON, NC 28401-7407
(910) 662-9300
(910) 662-9301
Mailing address
PO BOX 936857, ATLANTA, GA 31193-6857
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
—
—
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
Primary
—
—
207V00000X
Obstetrics & Gynecology Physician
—
—
208600000X
Surgery Physician
—
—
Other
Enumeration date
03/24/2021
Last updated
10/26/2021
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