OrganizationActive
Novant Medical Group, Inc.
NPI 1013453604 · Pediatric Gastroenterology Physician · Charlotte, NC
Provider details
- NPI number
- 1013453604
- Entity type
- Organization
- Primary specialty
- Pediatric Gastroenterology PhysicianAllopathic & Osteopathic Physicians
- Authorized official
- Shala Davis, Rcs Manager
Practice location
11840 Southmore Dr
Suite 200
Charlotte, NC 28277-4466
Phone: (704) 316-5060
Fax: (704) 316-5069
Mailing address
Po Box 60447
Charlotte, NC 28260-0447
Registry dates
- Enumerated
- 2017-01-06
- Last updated
- 2021-08-16
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.