Healthcare Provider Details

I. General information

NPI: 1508931544
Provider Name (Legal Business Name): NOVANT HEALTH ROWAN MEDICAL CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/22/2006
Last Update Date: 09/29/2025
Certification Date: 09/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

612 MOCKSVILLE AVE.
SALISBURY NC
28144-2732
US

IV. Provider business mailing address

2085 FRONTIS PLAZA BLVD FL 3
WINSTON SALEM NC
27103-5614
US

V. Phone/Fax

Practice location:
  • Phone: 704-210-5000
  • Fax:
Mailing address:
  • Phone: 336-277-8757
  • Fax: 336-718-8916

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number
License Number State

VIII. Authorized Official

Name: GARY BLABON
Title or Position: PRESIDENT & COO
Credential:
Phone: 336-277-8757