LAKESIDE DERMATOLOGY , PA
NPI 1619973054
Dermatology in Cornelius, NC

Active since June 21, 2005
19900 W CATAWBA AVE, SUITE B, CORNELIUS, NC 28031(704) 892-4878(704) 892-7453 Get Directions Write a Review

NPPES record last updated: March 23, 2011. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Lakeside Dermatology , Pa NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

LAKESIDE DERMATOLOGY , PA (NPI 1619973054) is a healthcare organization registered as a dermatology in Cornelius, North Carolina and active in the NPI registry since June 2005. The organization lists Nancy J Astle, President/physician, as its authorized official.

NPPES Registry Identity

NPI1619973054
Entity TypeOrganization
Primary Taxonomy207N00000X
Legal Business NameLAKESIDE DERMATOLOGY , PA
Location Address19900 W CATAWBA AVE, SUITE BCornelius, NC 28031-4032
Mailing Address19900 W Catawba Ave, Ste BCornelius, NC 28031-4032 · (704) 892-4878 · Fax (704) 892-7453
Fax(704) 892-7453
Organization SubpartNo
Authorized OfficialNancy J AstlePresident/physician · (704) 892-4878
Enumeration DateJune 21, 2005
Last NPPES UpdateMarch 23, 2011
NPI 1619973054 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyDermatologyAllopathic & Osteopathic Physicians
Taxonomy Code207N00000X
License Licensed in NC · 9400198
Definition
A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging.
19900 W CATAWBA AVE, Cornelius, NC 28031

Other Identifiers 5

OtherCA0767Railroad Medicare
OtherE82914Upin
Other01056NC · Bcbs
Medicare UPINE38564
Medicare ID-Type Unspecified2316408

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Other Providers at the Same Location NPPES 6

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Internal Medicine (Endocrinology, Diabetes & Metabolism)
19900 W CATAWBA AVE
CORNELIUS, NC 28031
Optometrist
19900 W CATAWBA AVE
CORNELIUS, NC 28031
Optometrist
19900 W CATAWBA AVE
CORNELIUS, NC 28031
Internal Medicine (Endocrinology, Diabetes & Metabolism)
19900 W CATAWBA AVE, SUITE C
CORNELIUS, NC 28031
Optometrist
19900 W CATAWBA AVE
CORNELIUS, NC 28031
Optometrist
19900 W CATAWBA AVE
CORNELIUS, NC 28031

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Lakeside Dermatology , PA's NPI number?

The NPI number for Lakeside Dermatology , PA is 1619973054. It was assigned to this organization in the NPPES registry on June 21, 2005.

Where is Lakeside Dermatology , PA located?

Lakeside Dermatology , PA is located at 19900 W Catawba Ave Suite B, Cornelius, NC 28031. The listed phone number is (704) 892-4878.

What is Lakeside Dermatology , PA's specialty?

The primary specialty registered for this NPI is Dermatology with taxonomy code 207N00000X.

When was this NPI record last updated?

The NPPES record for Lakeside Dermatology , PA was last updated on March 23, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.