Organization
NOVANT MEDICAL GROUP INC
Active
Other names
Novant Health Triad Surgical Associates
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GEOFFREY KEITH GARDNER (VP FINANCE)
(336) 765-0155
Entity
Organization
Contact information
Practice address
7126 VILLAGE MEDICAL CIR, CLEMMONS, NC 27012-8004
(336) 765-0155
(336) 765-5494
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
(336) 765-0155
(336) 765-5494
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1942636444
—
NC
Enumeration date
09/17/2013
Last updated
12/16/2014
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