Organization · Type 2 NPI

Novant Health Medical Group, LLC

Pediatric Gastroenterology Physician · Charlotte, NC

NPI number 1003966185 Active

Practice location

1918 Randolph Rd Ste 210
Charlotte, NC 28207-1109

Call (704) 316-5060 Map

Fax (704) 316-5069

Mailing address

PO Box 60447
Charlotte, NC 28260-0447

Other practice locations

1401 Matthews Township Pkwy Ste 100, Matthews, NC 28105-5403 · (704) 316-5060
2711 Randolph Rd, Suite 301, Charlotte, NC 28207-2027 · (704) 316-5060

Specialties and licenses

Taxonomy	Code	License
Pediatric Gastroenterology Physician Primary	2080P0206X	None listed

Pediatric Gastroenterology Physician: A pediatrician who specializes in the diagnosis and treatment of diseases of the digestive systems of infants, children and adolescents. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using lighted scopes to see internal organs.

9 other providers at this address

Other pediatric gastroenterology physician providers in Charlotte

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NPI record

NPI: 1003966185
Entity type: Organization (Type 2)
Issued: Jan 11, 2007
Last updated: Jul 31, 2025
Status: Active

Other names

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Novant Health Pediatric Gastroenterology · doing business as
Novant Health Pediatric Gastroenterology · doing business as

Authorized official

Leea Jeanine Walton
Edi Manager
(704) 316-6081

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1003966185

Novant Health Medical Group, LLC's National Provider Identifier is 1003966185, issued on Jan 11, 2007. The primary taxonomy on file is Pediatric Gastroenterology Physician (2080P0206X), and the practice location is in Charlotte, NC. The record was last updated on Jul 31, 2025.