Novant Health Medical Group, LLC
Pediatrics in Monroe, NC. Organization (NPI-2).
NPI number1023062452
StatusActive
Last updated in NPPESJun 20, 2024
Details
- NPI
- 1023062452
- Entity type
- Organization (NPI-2)
- Legal business name
- Novant Health Medical Group, LLC
- Organization subpart
- No
- Enumeration date
- May 20, 2006
- Certification date
- Jun 20, 2024
- Last updated
- Jun 20, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 208000000X | Pediatrics | – | – | Yes |
Other names
- Novant Health Child & Adolescent Medical Group (Doing Business As)
Practice location
1994 Wellness BlvdSuite 110
Monroe, NC 28110-7768
Phone 704-384-8460 · Fax 704-384-8465
Mailing address
Po Box 60447Charlotte, NC 28260-0447
Phone 704-384-8460 · Fax 704-384-8465
Authorized official
Leea Jeanine Walton
Rcs Manager
7043166081
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