Organization
LAKE NORMAN DERMATOLOGY, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOEL H SUGARMAN MD (PRESIDENT)
(704) 658-9730
Entity
Organization
Contact information
Practice address
140 LEANING OAK DRIVE, STE 101, MOORESVILLE, NC 28117-6991
(704) 658-9730
(704) 658-1457
Mailing address
140 LEANING OAK DRIVE, STE 101, MOORESVILLE, NC 28117-6991
(704) 658-9730
(704) 658-1457
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
200500264
NC
207N00000X
Dermatology Physician
200500264
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
021AU
BC/BS
—
01
—
14002
BCBS ID NUMBER
NC
Enumeration date
03/06/2007
Last updated
05/25/2021
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