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General NPI Number Information
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NPI Number | 1760282487
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Entity Type | Organization
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Legal Business Name | NOVANT HEALTH PIEDMONT NORTH CAROLINA MEDICAL GROUP, LLC
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Dates
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Enumeration Date | 03/13/2025
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Last Update Date | 04/21/2025
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Provider Practice Location Address
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Address Line | 2105 BRAXTON LN STE 101
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City | GREENSBORO
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State | NC
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Zip | 27408-2862
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Country | US
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Telephone | 336-333-6306
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Fax | 336-333-6309
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Provider Business Mailing Address
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Address Line | PO BOX 604345
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City | CHARLOTTE
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State | NC
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Zip | 28260-4345
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Country | US
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Telephone |
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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 | 336-515-7085
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number |
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License Number State |
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