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Organization

NOVANT HEALTH MEDICAL GROUP, LLC

Active
Other names
Novant Health Pediatric Cardiology
Organization subpart
No

Provider details

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

Contact information

Practice address
17810 STATESVILLE RD STE 311, CORNELIUS, NC 28031-8149
(704) 316-1220
(704) 316-1230
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
(704) 316-1220
(704) 316-1230

Taxonomy

Speciality
Code
Description
License number
State
2080P0202X
Pediatric Cardiology Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1881096907
NC
Enumeration date
09/19/2014
Last updated
06/14/2024
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