Healthcare Provider Details

I. General information

NPI: 1013884857
Provider Name (Legal Business Name): NMG HEALTH SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/17/2025
Last Update Date: 10/17/2025
Certification Date: 10/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6324 FAIRVIEW RD STE 440
CHARLOTTE NC
28210-4278
US

IV. Provider business mailing address

PO BOX 604136
CHARLOTTE NC
28260-4136
US

V. Phone/Fax

Practice location:
  • Phone: 704-384-1407
  • Fax: 704-384-1408
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number State

VIII. Authorized Official

Name: LEEA WALTON
Title or Position: MANAGER
Credential:
Phone: 704-316-6081