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Contact Information

LAKE NORMAN DERMATOLOGY, PA
140 LEANING OAK DRIVE
STE 101
MOORESVILLE, NC28117-6991
 Phone: 704-658-9730
 Fax: 704-658-1457
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Specialist

174400000X
 

Dermatology

207N00000X 07 Physician/Dermatology
Indicates primary specialty

NPI Profile & details for LAKE NORMAN DERMATOLOGY, PA

NPI # 1184754848
LBN Legal business name LAKE NORMAN DERMATOLOGY, PA
Authorized official JOEL SUGARMAN - (PRESIDENT)
Entity Organization
Organization subpart 1 No
Enumeration date 03/06/2007
Last updated 05/25/2021 - About 5 years ago
Identifiers
License # 200500264
NC License # 200500264
Other 021AU BC/BS
NC Other 14002 BCBS ID NUMBER
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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