Organization
LAKE NORMAN PEDIATRICS, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KIM M CAVIN (OFFICE MANAGER)
(704) 664-1297
Entity
Organization
Contact information
Practice address
656 CARPENTER AVE, MOORESVILLE, NC 28115-2538
(704) 664-1297
(704) 799-6356
Mailing address
656 CARPENTER AVE, MOORESVILLE, NC 28115-2538
(704) 664-1297
(704) 799-6356
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Enumeration date
04/26/2006
Last updated
08/22/2020
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