Lake Norman Ears Nose and Throat PA

Primary specialty

Otolaryngology PhysicianTaxonomy code 207Y00000X

Legal business name

LAKE NORMAN EARS NOSE AND THROAT PA

Practice address

140 Gateway Blvd
Mooresville, NC 28117

Phone

(704) 664-9638

Fax

(704) 664-1859

NPI assigned

Jul 10, 2006

Last updated

Dec 9, 2009By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Herbert Lee Wettreich, MDNPI 1215008545

Title

MD

Phone

(704) 664-9368

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Herbert Lee Wettreich, MD

  • Otolaryngology Physician
  • Mooresville, NC
  • NPI 1215008545
  Authorized official Same address or phone

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1152489600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1260316800000",
    "number": "1306870902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "140 GATEWAY BLVD",
            "city": "MOORESVILLE",
            "state": "NC",
            "postal_code": "28117",
            "telephone_number": "704-664-9638",
            "fax_number": "704-664-1859"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 GATEWAY BLVD",
            "city": "MOORESVILLE",
            "state": "NC",
            "postal_code": "28117",
            "telephone_number": "704-664-9638",
            "fax_number": "704-664-1859"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKE NORMAN EARS NOSE AND THROAT PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-10",
        "last_updated": "2009-12-09",
        "status": "A",
        "authorized_official_last_name": "WETTREICH",
        "authorized_official_first_name": "HERBERT",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "704-664-9368",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Otolaryngology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Otolaryngology Physician in Mooresville, NC
• Providers in Mooresville, NC by specialty
• Otolaryngology Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.