| Novant Health Randolph Family Medicine | |
|
1918 Randolph Rd Suite 275 Charlotte NC 28207-1109 | |
| (704) 384-1354 | |
| (704) 384-1374 |
| Full Name | Novant Health Randolph Family Medicine |
|---|---|
| Speciality | Family Medicine |
| Location | 1918 Randolph Rd, Charlotte, 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 Randolph Family Medicine Po Box 60447 Charlotte NC 28260-0447 Ph: (704) 384-1354 | Novant Health Randolph Family Medicine 1918 Randolph Rd Suite 275 Charlotte NC 28207-1109 Ph: (704) 384-1354 |
| NPI Number | 1801827324 |
|---|---|
| Provider Enumeration Date | 07/05/2006 |
| Last Update Date | 07/09/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801827324 | NPI | - | NPPES |
| CC5118 | Other | NC | RAILROAD MEDICARE |
| NPB161 | Medicaid | SC | |
| 89015FF | Medicaid | NC | |
| 0109U | Other | NC | BCBS-NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (North Carolina) | Primary |
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