# LAKE NORMAN ENDOCRINOLOGY & DIABETES, PC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1114205457
- **Authorized official:** AUGUSTINE U OBI M.D. (OWNER)
- **Authorized official phone:** (704) 664-2910

## Contact information

- **Practice address:** 143 JOE KNOX AVE, SUITE 100, MOORESVILLE, NC 28117-9243
- **Practice address phone:** (704) 664-2936
- **Mailing address:** 143 JOE KNOX AVE, SUITE 100, MOORESVILLE, NC 28117-9243
- **Mailing address phone:** (704) 664-2936

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207RE0101X | Endocrinology, Diabetes & Metabolism Physician | 9400602 | NC | Yes |

## Other

- **Enumeration date:** 08/03/2011
- **Last updated:** 09/26/2012

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 5918299 | — | NC |