Organization
SOUTHLAKE PSYCHIATRY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. THOMAS MICHAEL FITZGERALD MD (PRESIDENT)
(704) 894-9309
Entity
Organization
Contact information
Practice address
903 NORTHEAST DR, SUITE 301, DAVIDSON, NC 28036
(704) 894-9309
(704) 894-9304
Mailing address
903 NORTHEAST DR, SUITE 301, DAVIDSON, NC 28036-7416
(704) 894-9309
(704) 894-9304
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
9300112
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8932269
—
NC
01
—
B3348
BCBS
NC
Enumeration date
09/18/2007
Last updated
08/01/2025
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up