| Novant Health Medical Group, Llc | |
|
75 Emerson Bay Street Sw Suite 102 Carolina Shores NC 28467-2498 | |
| (910) 579-8363 | |
| (910) 579-8306 |
| Full Name | Novant Health Medical Group, Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 75 Emerson Bay Street Sw, Carolina Shores, North Carolina |
| Authorized Official Name and Position | Leea Jeanine Walton (RCS MANAGER) |
| Authorized Official Contact | 7043166081 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Novant Health Medical Group, Llc Po Box 60447 Charlotte NC 28260-0447 Ph: (910) 579-8363 | Novant Health Medical Group, Llc 75 Emerson Bay Street Sw Suite 102 Carolina Shores NC 28467-2498 Ph: (910) 579-8363 |
| NPI Number | 1548410996 |
|---|---|
| Provider Enumeration Date | 09/23/2008 |
| Last Update Date | 07/09/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548410996 | NPI | - | NPPES |
| CC5118 | Other | NC | RAILROAD MEDICARE |
| 5950530 | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |