Organization · Type 2 NPI

Novant Medical Group Inc

Neurology with Special Qualifications in Child Neurology Physician · Charlotte, NC

NPI number 1033675079 Active

Practice location

1918 Randolph Rd Ste 320
Charlotte, NC 28207-1109

Call (704) 384-1390 Map

Fax (704) 384-1063

Mailing address

PO Box 60447
Charlotte, NC 28260-0447

Specialties and licenses

Taxonomy	Code	License
Neurology with Special Qualifications in Child Neurology Physician Primary	2084N0402X	None listed

Neurology with Special Qualifications in Child Neurology Physician: A Child Neurologist specializes in neurology with special skills in diagnosis and treatment of neurologic disorders of the neonatal period, infancy, early childhood, and adolescence.

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NPI record

NPI: 1033675079
Entity type: Organization (Type 2)
Issued: Feb 14, 2019
Last updated: Aug 16, 2021
Status: Active

Other names

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Novant Health Pediatric Neurology · doing business as
Novant Health Pediatric Neurology · doing business as

Authorized official

Shala Davis
RCS Manager
(704) 303-7517

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About NPI 1033675079

Novant Medical Group Inc's National Provider Identifier is 1033675079, issued on Feb 14, 2019. The primary taxonomy on file is Neurology with Special Qualifications in Child Neurology Physician (2084N0402X), and the practice location is in Charlotte, NC. The record was last updated on Aug 16, 2021.