NC IMMUNOLOGY PC NPI 1619785920

NPI Information

  • NPI: 1619785920
  • Provider Name: NC IMMUNOLOGY, PC
  • Classification: Allergy & Immunology - 207KI0005X
  • Specialization: Clinical & Laboratory Immunology
  • Entity Type: Organization
  • CLIA Number: 34D2321154
  • Address: 1525 DAVIE AVE
    STATESVILLE, NC
    ZIP 28677
  • Phone: (704) 873-5055

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NPI Details

NC IMMUNOLOGY, PC is a clinical and laboratory immunology allergy immunology in Statesville, NC. The provider is an allergy and immunology physician who specializes in clinical and laboratory immunology disease management. Source: National Uniform Claim Committee, 2022 Additional Resources: A certification was, but is no longer, issued by the American Board of Allergy and Immunology. NC IMMUNOLOGY, PC NPI is 1619785920. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1525 DAVIE AVE
STATESVILLE, NC
ZIP 28677-517
Phone: (704) 873-5055
Fax: (704) 873-5025

The provider's authorized official is Frank J Lichtenberger .
The authorized official title is Md and has the following contact phone number (704) 873-5055.

The CLIA number assigned to this NPI record is 34D2321154 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 12/19/2024 and was last updated on 12/24/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207KI0005XAllergy & ImmunologyClinical & Laboratory ImmunologyYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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