Organization
NOVANT MEDICAL GROUP, INC.
Active
Other names
Lewisville Medical Center
Organization subpart
No
Provider details
NPI number
Authorized official
DINESH S. PAI (VP OF OPERATIONS)
(704) 384-9104
Entity
Organization
Contact information
Practice address
3248 EDGELAND HWY, RICHBURG, SC 29729-9478
(803) 789-6111
(803) 789-6118
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
(704) 384-7840
(704) 384-7830
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
12773
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GP4615
—
SC
Enumeration date
01/05/2007
Last updated
06/09/2008
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