Lakeside Dermatology , PA

NPI #1619973054 in Cornelius, North Carolina

Provider Information

NPI Number
1619973054
Entity Type
Organization
Organization Name
Lakeside Dermatology , PA
Primary Specialty
Dermatology
Enumeration Date
Jun 21, 2005
Last Updated
Mar 23, 2011

Practice Location

Address
19900 W CATAWBA AVE
Address 2
SUITE B
ZIP Code
28031-4032
Phone
(704) 892-4878

Authorized Official

Name
NANCY J ASTLE, MD
Title
PRESIDENT/PHYSICIAN
Phone
(704) 892-4878

Specialties & Taxonomy Codes

Specialty
Dermatology

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