Organization
LAKE NORMAN NEUROLOGY PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MICHELE M DUFORE (OFFICE MANAGER)
(704) 662-3077
Entity
Organization
Contact information
Practice address
124 PROFESSIONAL PARK DR, SUITE A, MOORESVILLE, NC 28117-5537
(704) 662-3077
(704) 662-3458
Mailing address
124 PROFESSIONAL PARK DR, SUITE A, MOORESVILLE, NC 28117-5537
(704) 662-3077
(704) 662-3458
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
89013KP
—
NC
Enumeration date
05/04/2006
Last updated
07/09/2008
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