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

Lakeshore Pediatric Center, PA

Organization Pediatrics Physician · NPI 1366650707

Lakeshore Pediatric Center, PA provides Pediatrics Physician services 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 Not confirmed with CMS for 15 years — call before visiting
Phone: (704) 489-8401
Fax: (704) 489-8404
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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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