Organization
LAKE NORMAN BARIATRICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TIMOTHY RYAN HEIDER MD (SURGEON)
(704) 402-2506
Entity
Organization
Contact information
Practice address
108 ALEXANDER BANK DR, SUITE 200, MOORESVILLE, NC 28117
(704) 660-4584
Mailing address
108 ALEXANDER BANK DR, SUITE 232, MOORESVILLE, NC 28117
(704) 660-4584
Taxonomy
Speciality
Code
Description
License number
State
3336C0002X
Clinic Pharmacy
Primary
—
—
Other
Enumeration date
11/20/2020
Last updated
11/20/2020
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