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NPI Code Detail

MEDICARE: NOVANT MEDICAL GROUP INC

MEDICARE: NOVANT MEDICAL GROUP INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207V00000XObstetrics & Gynecology Physician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1073898805
Entity Type Code : Organization
Provider Name (Legal Business Name) : NOVANT MEDICAL GROUP INC
Provider Business Mailing Address
First Line : PO BOX 60447
Second Line :
City : CHARLOTTE
State : NC
Zip : 28260-0447
Country : US
Telephone Number : 704-384-1620
Fax Number :
Provider Business Practice Location Address
First Line : 2610 WEST ARROWOOD ROAD
Second Line :
City : CHARLOTTE
State : NC
Zip : 28273-6134
Country : US
Telephone Number : 704-384-1620
Fax Number : 704-384-1626
Authorized Official
Title or Position : VP OF FINANCE
Name : GEOFFREY GARDNER
Credential :
Telephone Number : 704-384-1620
Provider Enumeration Date : 10/12/2011
Last Update Date : 11/29/2013

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Directions to “NOVANT MEDICAL GROUP INC ” Practice Location

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