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

Lakeshore Pediatric Center, PA

Organization Pediatrics Physician · NPI 1366650707

Lakeshore Pediatric Center, PA is a Pediatrics Physician in Denver, North Carolina. Licensed in North Carolina. Registered with an NPI since 2007.

Licensed in
NC
In the registry since
2007
What do these letters mean?
PA — Professional association
A form of business registration, not a clinical qualification.

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Practice location Address checks out

275 N Hwy 16 Suite: 103 Lakeshore Pediatric Ctr
Denver, NC 28037
Phone: (704) 489-8401
Fax: (704) 489-8404
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Pediatrics Physician (primary) Taxonomy 208000000X · Licence 2000-00103 (NC)

Record details

NPI number1366650707
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Wissam Nadra — President · (704) 489-8401
NPI enumeratedMay 18, 2007
Last updated in NPPESFebruary 4, 2011
Mailing address275 N Hwy 16, Suite: 103 Lakeshore Pediatric Center., Denver, NC 28037

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