| Organization Name: | NOVANT MEDICAL GROUP INC |
| NPI Number: | 1386019891 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | GEOFFREY K GARDNER (VP OF FINANCE) |
| Mailing Address: | 3614 Providence Rd S Suite 101 Waxhaw |
| State: | NC US |
| Postal Code: | 281736309 |
| Phone Number: | 7043848460 |
| Fax Number: | 7043848465 |
| NPI Enumeration Date: | 12/09/2015 |
| NPI Last Update Date: | 12/15/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2080A0000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Pediatrics |
| Taxonomy Specialization: | Adolescent Medicine |
| Taxonomy Definition: | 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. |