| NPI | 1952933301 |
|---|---|
| Doing Business As | NOVANT HEALTH NORTHLAKE DERMATOLOGY |
| Entity Type | Organization |
| Authorized Contact | SHALA DAVIS Enrollment Manager 704-316-7845 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology |
| Enumeration Date | 2020-02-04 |
| Last Update Date | 2020-02-04 |