Organization
LAKE NORMAN HEMATOLOGY AND ONCOLOGY SPECIALISTS PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RICHARD KRUMDIECK M.D. (PRESIDENT)
(704) 799-3946
Entity
Organization
Contact information
Practice address
170 MEDICAL PARK RD, SUITE 101, MOORESVILLE, NC 28117-8540
(704) 799-3946
(704) 799-3956
Mailing address
170 MEDICAL PARK RD, SUITE 101, MOORESVILLE, NC 28117-8540
(704) 799-3946
(704) 799-3956
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
—
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
012AX
BCBS OF NC
—
05
—
89012AX
—
NC
Enumeration date
06/28/2006
Last updated
04/11/2017
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