National Provider Identifier Database

LAKE NORMAN PLASTIC SURGERY
Specialist

An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.


Contact Information

LAKE NORMAN PLASTIC SURGERY
LAKE NORMAN MEDICAL & PROFESSIONAL PLAZA, SUITE 106
146 MEDICAL PARK RD.
MOORESVILLE, NC28117
Phone: 704-658-9921
Fax: 704-658-9928
Website:
Specialty Taxonomy Code
* Specialist 174400000X

* Indicates primary specialty

NPI Profile & details for LAKE NORMAN PLASTIC SURGERY

NPI Number 1710916960
Legal business name
LBN
LAKE NORMAN PLASTIC SURGERY
Authorized official ADAM RAVIN - (OWNER)
Entity Organization
Organization subpart No
Enumeration date 07/01/2006
Last updated 03/05/2009 - About 17 years ago
Sole proprietor1 Not specified
Identifiers
  • NC Other: 143AR BLUE CROSS AND BLUE SHIEL
  • NC Other: DO2646 RAILROAD MEDICARE
  • NC Other: P00667059 RAILROAD MEDICARE

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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