Organization · Type 2 NPI

Novant Medical Group, Inc.

Pediatric Gastroenterology Physician · Charlotte, NC

NPI number 1013453604 Active

Practice location

11840 Southmore Dr, Suite 200
Charlotte, NC 28277-4466

Call (704) 316-5060 Map

Fax (704) 316-5069

Mailing address

PO Box 60447
Charlotte, NC 28260-0447

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.

20 other providers at this address

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NPI record

NPI: 1013453604
Entity type: Organization (Type 2)
Issued: Jan 6, 2017
Last updated: Aug 16, 2021
Status: Active

Other names

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

Authorized official

Shala Davis
RCS Manager
(704) 303-7517

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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 1013453604

Novant Medical Group, Inc.'s National Provider Identifier is 1013453604, issued on Jan 6, 2017. The primary taxonomy on file is Pediatric Gastroenterology Physician (2080P0206X), and the practice location is in Charlotte, NC. The record was last updated on Aug 16, 2021.