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Organization
CAROLINAS MEDICAL CENTER-NORTHEAST
Active
Organization
CAROLINAS MEDICAL CENTER-NORTHEAST
Active
Parent organization
CAROLINAS MEDICAL CENTER-NORTHEAST
Other names
MIDLAND FAMILY MEDICINE
Organization subpart
Yes
Provider details
NPI number
Legal business name
CAROLINAS MEDICAL CENTER-NORTHEAST
Authorized official
FRIEDA M LOWDER (VP PHYSICIAN SERVICE)
(704) 403-4146
Entity
Organization
Contact information
Practice address
12925 HIGHWAY 601, SUITE 300, MIDLAND, NC 28107-9535
(704) 888-3702
(704) 888-4192
Mailing address
12925 HIGHWAY 601, SUITE 300, MIDLAND, NC 28107-9535
(704) 888-3702
(704) 888-4192
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
019F0
BCBS EFF 7-1-07
NC
01
—
0298R
BCBS EFF PRIOR TO 7-1-07
NC
01
—
355573
MAMSI GROUP
NC
01
—
566000156032
TRICARE STANDARD, NON NWK
NC
05
—
5906966
—
NC
05
—
790298R
—
NC
01
—
9805
PARTNERS MEDICARE CHOICE
NC
01
—
CC2854
RAILROAD MEDICARE GROUP
NC
01
—
DF8926
RAILROAD MEDICARE PTAN
NC
Enumeration date
05/27/2006
Last updated
12/03/2013
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