# CAROLINAS MEDICAL CENTER-NORTHEAST

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** CAROLINAS MEDICAL CENTER-NORTHEAST
- **Other names:** MIDLAND FAMILY MEDICINE
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1073560850
- **Legal business name:** CAROLINAS MEDICAL CENTER-NORTHEAST
- **Authorized official:** FRIEDA M LOWDER (VP PHYSICIAN SERVICE)
- **Authorized official phone:** (704) 403-4146

## Contact information

- **Practice address:** 12925 HIGHWAY 601, SUITE 300, MIDLAND, NC 28107-9535
- **Practice address phone:** (704) 888-3702
- **Practice address fax:** (704) 888-4192
- **Mailing address:** 12925 HIGHWAY 601, SUITE 300, MIDLAND, NC 28107-9535
- **Mailing address phone:** (704) 888-3702
- **Mailing address fax:** (704) 888-4192

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 05/27/2006
- **Last updated:** 12/03/2013

## 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 |