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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 Specialty Code Provider Type

Specialist

174400000X
Indicates primary specialty

NPI Profile & details for LAKE NORMAN PLASTIC SURGERY

NPI Number 1710916960
LBN Legal business name LAKE NORMAN PLASTIC SURGERY
Authorized official ADAM RAVIN - (OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 07/01/2006
Last updated 03/05/2009 - About 17 years ago
Identifiers
NC Other 143AR BLUE CROSS AND BLUE SHIEL
NC Other DO2646 RAILROAD MEDICARE
NC Other P00667059 RAILROAD MEDICARE
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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