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NOVANT MEDICAL GROUP INC. NPI 1780626374


NPI Information

NPI: 1780626374
Provider Name: NOVANT MEDICAL GROUP, INC.

Doing Business As: NOVANT HEALTH RANDOLPH OB/GYN

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

CLIA Number: 34D0244241

Address:
2711 RANDOLPH RD
SUITE 512
CHARLOTTE, NC
ZIP 28207
Phone: (704) 333-4104
Get Directions

NOVANT MEDICAL GROUP, INC. is an obstetrics gynecology in Charlotte, 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 1780626374. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Novant Health Randolph Ob/gyn.

The provider's business location address is:

2711 RANDOLPH RD
SUITE 512
CHARLOTTE, NC
ZIP 28207-027
Phone: (704) 333-4104
Fax: (704) 358-4544

The provider's authorized official is Geoffrey K. Gardner .
The authorized official title is Vp Of Finance and has the following contact phone number (704) 384-9094.

The CLIA number assigned to this NPI record is 34D0244241 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 6/11/2006 and was last updated on 6/21/2013.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207V00000XObstetrics & GynecologyNORTH CAROLINAYes

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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1011V1OTHERNORTH CAROLINABCBS
22308634BMEDICARE PINNORTH 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: 11/14/2023

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