Organization
LAKE NORMAN OPHTHALMOLOGY PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TUSHAR PATEL MD (OWNER)
(704) 663-7226
Entity
Organization
Contact information
Practice address
132 GATEWAY BLVD STE C, MOORESVILLE, NC 28117-5540
(704) 662-3875
(704) 662-3875
Mailing address
132 GATEWAY BLVD STE C, MOORESVILLE, NC 28117-5540
(704) 662-3875
(704) 662-3875
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
89015UE
—
NC
Enumeration date
01/09/2007
Last updated
08/14/2023
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