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General NPI Number Information
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NPI Number | 1932073541
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Entity Type | Organization
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Legal Business Name | NOVANT HEALTH MEDICAL GROUP COASTAL REGION, LLC
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Dates
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Enumeration Date | 10/06/2025
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Last Update Date | 10/06/2025
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Provider Practice Location Address
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Address Line | 109 SCOTTS HILL MEDICAL DR STE 100A
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City | WILMINGTON
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State | NC
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Zip | 28411
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Country | US
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Telephone | 910-667-3000
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Fax | 910-338-0965
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Provider Business Mailing Address
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Address Line | PO BOX 936857
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City | ATLANTA
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State | GA
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Zip | 31193-6857
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Country | US
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Telephone | 910-667-3000
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Fax | 910-338-0965
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Authorized Official
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Title or Position | RCS MANAGER
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Name | LEEA JEANINE 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 | 207VX0201X
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Taxonomy Name | Gynecologic Oncology Physician
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License Number |
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License Number State |
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