Organization · Type 2 NPI

Novant Health Medical Group, LLC

Pediatric Adolescent Medicine Physician · Waxhaw, NC

NPI number 1386019891 Active

Practice location

3614 Providence Rd S, Suite 101
Waxhaw, NC 28173-6309

Call (704) 384-8460 Map

Fax (704) 384-8465

Mailing address

PO Box 60447
Charlotte, NC 28260-0447

Specialties and licenses

Taxonomy	Code	License
Pediatric Adolescent Medicine Physician Primary	2080A0000X	None listed

Pediatric Adolescent Medicine Physician: A pediatrician who specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs.

6 other providers at this address

NPI record

NPI: 1386019891
Entity type: Organization (Type 2)
Issued: Dec 9, 2015
Last updated: Jun 20, 2024
Status: Active

Other names

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Novant Health Child and Adolescent Medical Group · doing business as
Novant Health Child and Adolescent Medical Group · doing business as

Authorized official

Leea Jeanine Walton
RCS 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 1386019891

Novant Health Medical Group, LLC's National Provider Identifier is 1386019891, issued on Dec 9, 2015. The primary taxonomy on file is Pediatric Adolescent Medicine Physician (2080A0000X), and the practice location is in Waxhaw, NC. The record was last updated on Jun 20, 2024.