Organization
NOVANT HEALTH MEDICAL GROUP, LLC
Active
Other names
Novant Health Orthopedics & Sports Medicine, Novant Health Perry & Cook Orthopedics & Sports Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
LEEA JEANINE WALTON (RCS MANAGER)
(704) 316-6081
Entity
Organization
Contact information
Practice address
2826 RANDOLPH RD, CHARLOTTE, NC 28211-1386
(704) 358-0308
(704) 358-0039
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
(704) 358-0308
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5867080010
DME PTAN
NC
Enumeration date
05/04/2009
Last updated
07/11/2024
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