Novant Health Medical Group Coastal Region, LLC
Organization Active NPI Family Medicine Physician · Jacksonville, NC
NPI 1922767243 · NPPES record last updated Dec 14, 2021
Key facts
- NPI
- 1922767243
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Family Medicine Physician 207Q00000X
- Legal business name
- NOVANT HEALTH MEDICAL GROUP COASTAL REGION, LLC
- Practice address
- 2000 Brabham Ave
Jacksonville, NC 28546-0201 - Phone
- (910) 376-3025
- Fax
- (910) 362-9123
- NPI assigned
- Dec 14, 2021
- Organization subpart
- No
Authorized official
- Name
- Shala Davis
- Title
- RCS Manager
- Phone
- (704) 303-7517
Corporate family (same tax ID) 17
National Provider Directory
- Tax ID family
- Novant Health Medical Group Coastal Region LLC
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | Yes |
Addresses
Primary practice location
2000 Brabham Ave
Jacksonville, NC 28546-0201
Mailing address
PO Box 936857
Atlanta, GA 31193-6857
Other names
- NHMGCR Family Medicine
Other providers in Jacksonville, NC
- North Carolina CVS Pharmacy LLC
- North Carolina CVS Pharmacy LLC
- North Carolina Inpatient Medicine Associates PLLC
- Northwoods Drug Co Inc
- Novant Health Medical Group Coastal Region, LLC
- Maria De Fatima Novo
- Justine Nuckols
- Nuday Companion Care Services
- James Jay Nunalee Jr.
- Austin Uzoma Nwameme
All providers in Jacksonville, NC · Family Medicine Physician in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 14, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.