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General NPI Number Information
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NPI Number | 1710800651
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Entity Type | Organization
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Legal Business Name | NOVANT HEALTH NORTHERN REGIONAL MEDICAL CENTER, LLC
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Dates
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Enumeration Date | 07/30/2026
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Last Update Date | 07/30/2026
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Provider Practice Location Address
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Address Line | 1016 S SOUTH ST
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City | MOUNT AIRY
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State | NC
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Zip | 27030-5330
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Country | US
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Telephone | 336-783-8900
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 604408
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City | CHARLOTTE
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State | NC
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Zip | 28260-4408
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Country | US
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Telephone | 980-302-8360
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Fax |
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Authorized Official
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Title or Position | RCS MANAGER
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Name | LEEA WALTON
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Credential |
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Telephone | 704-316-6081
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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