Organization
LAKE NORMAN MEDICAL, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RONALD ADAMS (AUTHORIZED OFFICIAL)
(704) 495-2470
Entity
Organization
Contact information
Practice address
1661 DAVIE AVE, STATESVILLE, NC 28677-3519
(704) 495-2470
Mailing address
1661 DAVIE AVE, STATESVILLE, NC 28677-3519
(704) 495-2470
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
—
Other
Enumeration date
03/09/2020
Last updated
10/26/2021
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