Lake Norman Plastic Surgery

NPI #1710916960 in Mooresville, North Carolina

Provider Information

NPI Number: 1710916960
Entity Type: Organization
Organization Name: Lake Norman Plastic Surgery
Primary Specialty: Specialist
Enumeration Date: Jul 1, 2006
Last Updated: Mar 5, 2009

Practice Location

Address: LAKE NORMAN MEDICAL & PROFESSIONAL PLAZA, SUITE 106
Address 2: 146 MEDICAL PARK RD.
City: Mooresville
State: North Carolina
ZIP Code: 28117
Phone: (704) 658-9921

Authorized Official

Name: ADAM G RAVIN, MD
Title: OWNER
Phone: (704) 658-9921

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Specialist	174400000X	Primary

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