Organization
LAKE NORMAN ENDOCRINOLOGY & DIABETES, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AUGUSTINE U OBI M.D. (OWNER)
(704) 664-2910
Entity
Organization
Contact information
Practice address
143 JOE KNOX AVE, SUITE 100, MOORESVILLE, NC 28117-9243
(704) 664-2936
Mailing address
143 JOE KNOX AVE, SUITE 100, MOORESVILLE, NC 28117-9243
(704) 664-2936
Taxonomy
Speciality
Code
Description
License number
State
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
9400602
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5918299
—
NC
Enumeration date
08/03/2011
Last updated
09/26/2012
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