Organization
NOVANT MEDICAL GROUP INC
Active
Other names
Novant Health Catalyst Family & Sports Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GEOFFERY K GARDNER (VP FINANCE)
(919) 497-3526
Entity
Organization
Contact information
Practice address
205 SANDALWOOD AVE, SUITE A, LOUISBURG, NC 27549-2679
(919) 497-3526
(919) 497-3539
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
(919) 497-3526
(919) 497-3539
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5921899
—
NC
Enumeration date
11/05/2012
Last updated
08/28/2013
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