Pediatric Gastroenterology Associates (Satellite)

LBN: Novant Medical Group Inc
Pediatric Gastroenterology Associates (Satellite) is an health care organization with primary practice located at 16139 Lancaster Hwy Suite 110, Charlotte NC 28277-2033. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatric Gastroenterology, which is considered as the primary health care specialty. Novant Medical Group Inc can be contacted via phone (704) 316-5060, or through Gardner, Geoffrey via phone (704) 384-9094.

Contact Information

Primary practice address
16139 Lancaster Hwy Suite 110 Charlotte NC 28277-2033
Phone: (704) 316-5060
Fax: (704) 316-5069
Website:
Map and Directions
Authorized official contact:
Name: Gardner, Geoffrey
Phone: (704) 384-9094

Health care specialties

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

Profile Details

NPI number 1164705653
LBN Legal business name Novant Medical Group Inc
DBA Doing business as Pediatric Gastroenterology Associates (Satellite)
Authorized official Gardner, Geoffrey
Entity Organization
Organization subpart 1 No
Enumeration date Sep 21st, 2011
Last updated Sep 29th, 2016 - about 9 years ago

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 1164705653 NPPES
North Carolina MEDICAID 5919443

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