Novant Health Pine Lake Family Physicians

LBN: Novant Medical Group, Inc.
Novant Health Pine Lake Family Physicians is an health care organization with primary practice located at 4105 Matthews Mint Hill Rd , Mint Hill NC 28105-3633. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as the primary health care specialty. Novant Medical Group, Inc. can be contacted via phone (704) 384-9920, or through Gardner, Geoffery K via phone (704) 384-7606.

Contact Information

Primary practice address
4105 Matthews Mint Hill Rd Mint Hill NC 28105-3633
Phone: (704) 384-9920
Fax: (704) 384-9925
Website:
Map and Directions
Authorized official contact:
Name: Gardner, Geoffery K
Phone: (704) 384-7606

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X North Carolina

Profile Details

NPI number 1518967546
LBN Legal business name Novant Medical Group, Inc.
DBA Doing business as Novant Health Pine Lake Family Physicians
Authorized official Gardner, Geoffery K
Entity Organization
Organization subpart 1 No
Enumeration date Aug 1st, 2005
Last updated Jul 26th, 2013 - about 13 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1518967546 NPPES
North Carolina MEDICAID 790209N
North Carolina MEDICAID NPA894

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