| Novant Health Gilead Road Pediatrics & Internal Medicine | |
|
9615 Kincey Avenue Suite 100 Huntersville NC 28078-9140 | |
| (704) 316-5635 | |
| (704) 316-5640 |
| Full Name | Novant Health Gilead Road Pediatrics & Internal Medicine |
|---|---|
| Speciality | Pediatrics |
| Location | 9615 Kincey Avenue, Huntersville, 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 Gilead Road Pediatrics & Internal Medicine Po Box 60447 Charlotte NC 28260-0447 Ph: (704) 384-7840 | Novant Health Gilead Road Pediatrics & Internal Medicine 9615 Kincey Avenue Suite 100 Huntersville NC 28078-9140 Ph: (704) 316-5635 |
| NPI Number | 1013969674 |
|---|---|
| Provider Enumeration Date | 05/16/2006 |
| Last Update Date | 06/20/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013969674 | NPI | - | NPPES |
| 017F5 | Other | NC | BCBS-NC |
| 5902021 | Medicaid | NC | |
| CC5118 | Other | NC | RAILROAD MEDICARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (North Carolina) | Secondary |
| 208000000X | Pediatrics | (North Carolina) | Primary |
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