| Novant Health Psychiatric Medicine | |
|
512 Village Rd Ste 104 Shallotte NC 28470-3409 | |
| (910) 721-4200 | |
| (910) 754-3811 |
| Full Name | Novant Health Psychiatric Medicine |
|---|---|
| Speciality | Psychiatry & Neurology - Psychiatry |
| Location | 512 Village Rd Ste 104, Shallotte, North Carolina |
| Authorized Official Name and Position | Leea Jeanine Walton (RCS MANAGER) |
| Authorized Official Contact | 7043166081 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Novant Health Psychiatric Medicine Po Box 60447 Charlotte NC 28260-0447 Ph: (910) 721-4200 | Novant Health Psychiatric Medicine 512 Village Rd Ste 104 Shallotte NC 28470-3409 Ph: (910) 721-4200 |
| NPI Number | 1124579750 |
|---|---|
| Provider Enumeration Date | 10/19/2016 |
| Last Update Date | 06/24/2024 |
| Certification Date | 06/24/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124579750 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | (* (Not Available)) | Secondary |
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
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