| NPI | 1003567082 |
|---|---|
| Doing Business As | LAKE NORMAN MEDICAL GROUP HEART & VASCULAR STATESVILLE |
| Entity Type | Organization |
| Authorized Contact | JENNIFER L JACKSON Sr Dir Prov Enroll & Onboarding 615-465-3334 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207RI0011X Internal Medicine, Interventional Cardiology |
| Enumeration Date | 2022-01-12 |
| Last Update Date | 2022-01-12 |