Novant Health Pediatric Gastroenterology

LBN: Novant Health Medical Group, Llc
Novant Health Pediatric Gastroenterology is an health care organization with primary practice located at 2711 Randolph Rd Suite 301, Charlotte NC 28207-2027. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatric Gastroenterology, which is considered as the primary health care specialty. Novant Health Medical Group, Llc can be contacted via phone (704) 316-5060, or through Walton, Leea Jeanine via phone (704) 316-6081.

Contact Information

Primary practice address
2711 Randolph Rd Suite 301 Charlotte NC 28207-2027
Fax: (704) 316-5069
Website:
Authorized official contact:
Name: Walton, Leea Jeanine

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatric Gastroenterology 2080P0206X North Carolina

Profile Details

NPI number 1003966185
LBN Legal business name Novant Health Medical Group, Llc
DBA Doing business as Novant Health Pediatric Gastroenterology
Authorized official Walton, Leea Jeanine
Entity Organization
Organization subpart 1 No
Enumeration date Jan 11th, 2007
Last updated Jun 20th, 2024 - about last year

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1003966185 NPPES
North Carolina Other 018WH BCBS NC
North Carolina MEDICAID NPB219 BCBS NC
North Carolina MEDICAID 5905866 BCBS NC

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