Northlake Pediatric Care Pa
Pediatrics
Northlake Pediatric Care Pa is a Statesville, North Carolina based Pediatric center with medical specialization in
General Pediatrics.
It is located at
2117 Simonton Rd, Suite 402, Statesville, North Carolina - 28625-8206. They can be contacted on phone at
704-871-2323 and fax number 803-619-2149.
NPI number (Unique professional ID) for Northlake Pediatric Care Pa is
1083729701 which was assigned by NPPES on 20 Aug, 2006 and it was last updated on 30 May, 2013.
Northlake Pediatric Care Pa is a pediatrician who is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
Complete Profile:
Northlake Pediatric Care Pa basic information including their official name, gender, specialization, credentials etc. are as mentioned below.
| Specialization : | Pediatrics |
|---|
| Provider Name : | Northlake Pediatric Care Pa |
|---|
Business Address:
Northlake Pediatric Care Pa address, contact phone number and fax are as below. Patients can directly walkin to the clinic or can call on the below given phone number for appointment.
| Primary Address : | 2117 Simonton Rd, Suite 402
Statesville, NC, 28625-8206
United States |
|---|
| Phone Number : | 704-871-2323 |
|---|
| Fax Number : | 803-619-2149 |
|---|
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). NPI details are as mentioned below.
| NPI Number : | 1083729701 |
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| NPI Entity Type : | Organization |
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| First Enrolment Date : | 20 Aug, 2006 |
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| Last Updated On : | 30 May, 2013 |
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Authorized Official Details:
Officially authorized person to contact for any management issues or complaints of this organization are as below. Person's position and contact details are as mentioned below.
| Authorized Official Name : | Michael Borja |
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| Authorized Official Credential : | MD |
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| Official Title or Position : | OWNER |
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| Phone Number : | 704-871-2323 |
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Licenses and Specialities:
Physicians/Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Northlake Pediatric Care Pa are as mentioned. Primary taxonomy code for Northlake Pediatric Care Pa is
208000000X (Pediatrics).
| Taxonomy Code | Speciality | Primary | License No. | State |
|---|
| 208000000X | Pediatrics | Yes | | |
Legacy Identifiers:
Other legacy medical identifiers of Northlake Pediatric Care Pa such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned below.
| Identifier | Identifier Type | State | Issuer |
|---|
| 1002P | Other | NC | BCBS OF NC |
| 5918872 | MEDICAID | NC | |
| 34D1014813 | Other | | CLIA ID |
| ========= | Other | NC | TAX ID NUMBER |
Mailing Address:
Mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned business address only.
| Mailing Address : | 2117 Simonton Rd, Suite 402
Statesville, NC, 28625-8206
United States |
|---|
| Phone Number : | 704-871-2323 |
|---|
| Fax Number : | 803-619-2149 |
|---|
Business Location:
Patients can refer following map for directions to
Northlake Pediatric Care Pa practice address. Don't forget to take prior appointment before visiting.
** Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES.