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Novant Health Medical Group, LLC — NPI 1003966185, Charlotte, NC | NPI Central

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NPI 1003966185

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Novant Health Medical Group, LLC

NPI 1003966185 · Pediatric Gastroenterology Physician · Charlotte, NC

Provider details

NPI number: 1003966185
Entity type: Organization
Primary specialty: Pediatric Gastroenterology PhysicianAllopathic & Osteopathic Physicians
Organization subpart: No
Authorized official: Leea Walton, Edi Manager(704) 316-6081

Specialties & taxonomies

Pediatric Gastroenterology PhysicianPrimary2080P0206X
Allopathic & Osteopathic Physicians

Practice location

1918 Randolph Rd Ste 210

Charlotte, NC 28207-1109

Phone: (704) 316-5060

Fax: (704) 316-5069

Approximate (ZIP-level) locationGet directions

More NC providers

Mailing address

Po Box 60447

Charlotte, NC 28260-0447

Other names (DBA / former)

Doing business as: Novant Health Pediatric Gastroenterology
Doing business as: Novant Health Pediatric Gastroenterology

Additional practice locations (2)

2711 Randolph Rd
Suite 301
Charlotte, NC 28207-2027
Phone: (704) 316-5060
Fax: (704) 316-5069
1401 Matthews Township Pkwy Ste 100
Matthews, NC 28105-5403
Phone: (704) 316-5060
Fax: (704) 316-5069

Registry dates

Enumerated: 2007-01-11
Last updated: 2025-07-31
Certified: 2025-07-31

Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.