Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Lake Norman Plastic Surgery

Organization Specialist · NPI 1710916960

Lake Norman Plastic Surgery is a Specialist in Mooresville, North Carolina. Registered with an NPI since 2006.

In the registry since
2006

Practice location Address checks out

Lake Norman Medical & Professional Plz Ste 106 146 Medical Park RD
Mooresville, NC 28117
Phone: (704) 658-9921
Fax: (704) 658-9928
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Specialist (primary) Taxonomy 174400000X

Record details

NPI number1710916960
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Adam Ravin — Owner · (704) 658-9921
NPI enumeratedJuly 1, 2006
Last updated in NPPESMarch 5, 2009
Mailing addressPo Box 15133, Durham, NC 27704-0133

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