Novant Health Medical Group, LLC
Psychiatry & Neurology, Neurology in Charlotte, NC. Organization (NPI-2).
NPI number1679110621
StatusActive
Last updated in NPPESJun 12, 2024
Details
- NPI
- 1679110621
- Entity type
- Organization (NPI-2)
- Legal business name
- Novant Health Medical Group, LLC
- Organization subpart
- No
- Enumeration date
- Dec 9, 2019
- Certification date
- Jun 12, 2024
- Last updated
- Jun 12, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology, Neurology | – | – | Yes |
Other names
- Novant Health Neurology & Headache (Doing Business As)
Practice location
6324 Fairview Rd Ste 400Charlotte, NC 28210-4278
Phone 980-302-8626 · Fax 980-302-8639
Mailing address
Po Box 60447Charlotte, NC 28260-0447
Phone 980-302-8626 · Fax 980-302-8639
Authorized official
Leea Jeanine Walton
Rcs Manager
7043166081
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