Provider Type Icon

NOVANT MEDICAL GROUP INC NPI 1205884970


NPI Information

NPI: 1205884970
Provider Name: NOVANT MEDICAL GROUP INC

Doing Business As: NOVANT HEALTH OB/GYN

Classification: Obstetrics & Gynecology - 207V00000X
Entity Type: Organization

CLIA Number: 34D1066742

Address:
584 HOSPITAL DR NE UNIT B
BOLIVIA, NC
ZIP 28422
Phone: (910) 721-4050
Get Directions

NOVANT MEDICAL GROUP INC is an obstetrics gynecology in Bolivia, NC. The provider is an obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. NOVANT MEDICAL GROUP INC NPI is 1205884970. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Novant Health Ob/gyn.

The provider's business location address is:

584 HOSPITAL DR NE UNIT B
BOLIVIA, NC
ZIP 28422-020
Phone: (910) 721-4050
Fax: (910) 721-4051

The provider's authorized official is Leea Jeanine Walton .
The authorized official title is Edi Manager and has the following contact phone number (704) 316-6081.

The CLIA number assigned to this NPI record is 34D1066742 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 5/5/2006 and was last updated on 7/11/2023.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207V00000XObstetrics & GynecologyYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
15903335MEDICAIDNORTH CAROLINA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.