| Novant Medical Group, Inc. | |
|
10320 Mallard Creek Rd Suite 120 Charlotte NC 28262-5204 | |
| (704) 384-0570 | |
| (704) 384-0571 |
| Full Name | Novant Medical Group, Inc. |
|---|---|
| Speciality | Internal Medicine |
| Location | 10320 Mallard Creek Rd, Charlotte, North Carolina |
| Authorized Official Name and Position | Geoffrey Gardner (VP FINANCE) |
| Authorized Official Contact | 7043849144 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Novant Medical Group, Inc. Po Box 60447 Charlotte NC 28260-0447 Ph: (704) 384-0570 | Novant Medical Group, Inc. 10320 Mallard Creek Rd Suite 120 Charlotte NC 28262-5204 Ph: (704) 384-0570 |
| NPI Number | 1386667368 |
|---|---|
| Provider Enumeration Date | 07/25/2006 |
| Last Update Date | 11/29/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386667368 | NPI | - | NPPES |
| 017WR | Other | NC | BCBS |
| CC5118 | Other | NC | RAILROAD MEDICARE |
| 5903443 | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| 208000000X | Pediatrics | (* (Not Available)) | Secondary |
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