NEOGENIX LAKE NORMAN PC NPI 1730903436

NPI Information

  • NPI: 1730903436
  • Provider Name: NEOGENIX LAKE NORMAN, PC
  • Classification: Clinic/Center - 261QM2500X
  • Specialization: Medical Specialty
  • Entity Type: Organization
  • Address: 19475 OLD JETTON RD STE 102
    CORNELIUS, NC
    ZIP 28031
  • Phone: (704) 727-6551

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NPI Details

NEOGENIX LAKE NORMAN, PC is a medical specialty clinic center in Cornelius, NC. The provider is an entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer). NEOGENIX LAKE NORMAN, PC NPI is 1730903436. The provider is registered as an organization entity type.

The provider's business location address is:

19475 OLD JETTON RD STE 102
CORNELIUS, NC
ZIP 28031-591
Phone: (704) 727-6551
Fax: (704) 669-8670

The provider's authorized official is Nikitas William Miles .
The authorized official title is Director Of Operations and has the following contact phone number (704) 727-6551.

The enumeration date for this NPI number is 11/11/2024 and was last updated on 11/11/2024.

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
1261QM2500XClinic/CenterMedical SpecialtyYes

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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