Organization
NOVANT MEDICAL GROUP INC
Active
Other names
Novant Health Peachview Family Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
GEOFFREY K. GARDNER (VP OF FINANCE)
(704) 384-9094
Entity
Organization
Contact information
Practice address
722 HYATT ST, SUITE B, GAFFNEY, SC 29341-2643
(864) 488-1400
(864) 488-1057
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
(864) 488-1400
(864) 488-1057
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GP5091
—
SC
Enumeration date
01/08/2009
Last updated
05/31/2013
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