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Organization

NOVANT MEDICAL GROUP INC

Active
Other names
Brunswick Coast Pediatrics
Organization subpart
No

Provider details

NPI number
Authorized official
MR. GEOFFREY GARDNER (VP FINANCE)
(704) 384-9094
Entity
Organization

Contact information

Practice address
10 DOCTORS CIR, SUITE 6, SUPPLY, NC 28462-4217
(910) 754-9028
(910) 754-5365
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary

Other

Enumeration date
06/04/2010
Last updated
06/04/2010
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