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NOVANT MEDICAL GROUP INC. NPI 1396751640


NPI Information

NPI: 1396751640
Provider Name: NOVANT MEDICAL GROUP, INC.

Doing Business As: NOVANT HEALTH NORTHLAKE DERMATOLOGY

Classification: Dermatology - 207ND0900X
Entity Type: Organization

Specialization: Dermatopathology

CLIA Number: 34D1058814

Address:
9604 HOLLY POINT DR
HUNTERSVILLE, NC
ZIP 28078
Phone: (704) 316-5070
Get Directions

NOVANT MEDICAL GROUP, INC. is a dermatopathology dermatology in Huntersville, NC. The provider is a dermatopathologist has the expertise to diagnose and monitor diseases of the skin including infectious, immunologic, degenerative and neoplastic diseases. This entails the examination and interpretation of specially prepared tissue sections, cellular scrapings and smears of skin lesions by means of routine and special (electron and fluorescent) microscopes. NOVANT MEDICAL GROUP, INC. NPI is 1396751640. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Novant Health Northlake Dermatology.

The provider's business location address is:

9604 HOLLY POINT DR
HUNTERSVILLE, NC
ZIP 28078-913
Phone: (704) 316-5070
Fax: (704) 316-5075

The provider's authorized official is Leea Jeanine Walton .
The authorized official title is Rcs Manager and has the following contact phone number (704) 316-6081.

The CLIA number assigned to this NPI record is 34D1058814 - physician office with a certificate type of Certificate of Compliance.

The enumeration date for this NPI number is 7/31/2006 and was last updated on 7/11/2023.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207N00000XDermatologyNo
2207ND0900XDermatologyDermatopathologyYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
15904331MEDICAIDNORTH CAROLINA
2NPB181MEDICAIDSOUTH CAROLINA
3018GVOTHERNORTH CAROLINABCBS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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