Organization
NOVANT HEALTH MEDICAL GROUP, LLC
Active
Other names
Novant Health Twin City Pediatrics
Organization subpart
No
Provider details
NPI number
Authorized official
LEEA JEANINE WALTON (RCS MANAGER)
(704) 316-6081
Entity
Organization
Contact information
Practice address
2821 MAPLEWOOD AVE, WINSTON SALEM, NC 27103-4137
(336) 718-3960
(336) 718-3998
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Enumeration date
09/24/2021
Last updated
06/21/2024
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