| Lake Norman Neurology Pa | |
|
124 Professional Park Dr Suite A Mooresville NC 28117-5537 | |
| (704) 662-3077 | |
| (704) 662-3458 |
| Full Name | Lake Norman Neurology Pa |
|---|---|
| Speciality | Psychiatry & Neurology - Neurology |
| Location | 124 Professional Park Dr, Mooresville, North Carolina |
| Authorized Official Name and Position | Michele M Dufore (OFFICE MANAGER) |
| Authorized Official Contact | 7046623077 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lake Norman Neurology Pa 124 Professional Park Dr Suite A Mooresville NC 28117-5537 Ph: (704) 662-3077 | Lake Norman Neurology Pa 124 Professional Park Dr Suite A Mooresville NC 28117-5537 Ph: (704) 662-3077 |
| NPI Number | 1356399554 |
|---|---|
| Provider Enumeration Date | 05/04/2006 |
| Last Update Date | 07/09/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356399554 | NPI | - | NPPES |
| 89013KP | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | (* (Not Available)) | Primary |
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The Center At Lake Norman Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 132 Joe Knox Ave Ste 100, Mooresville, NC 28117 Phone: 704-980-9234 Fax: 866-321-9367 | |
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