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 provides Specialist services 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 Not confirmed with CMS for 17 years — call before visiting
Phone: (704) 658-9921
Fax: (704) 658-9928
Show map & directions

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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