Organization
NOVANT MEDICAL GROUP, INC.
Active
Other names
Novant Health Blume Pediatric Hematology & Oncology
Organization subpart
No
Provider details
NPI number
Authorized official
GEOFFREY K GARDNER (VP FINANCE)
(704) 384-1900
Entity
Organization
Contact information
Practice address
301 HAWTHORNE LN, SUITE 100, CHARLOTTE, NC 28204-2450
(704) 384-1900
(704) 384-1919
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
(704) 384-7840
(704) 384-7830
Taxonomy
Speciality
Code
Description
License number
State
2080P0207X
Pediatric Hematology & Oncology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
011UJ
BCBS
NC
05
—
89011UJ
—
NC
05
—
NPA924
—
SC
Enumeration date
06/14/2006
Last updated
07/16/2013
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