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Organization
CAROLINAS MEDICAL CENTER
Active
Organization
CAROLINAS MEDICAL CENTER
Active
Parent organization
CAROLINAS MEDICAL CENTER
Other names
Carolinas Rehabilitation Northeast Physician Clinic
Organization subpart
Yes
Provider details
NPI number
Legal business name
CAROLINAS MEDICAL CENTER
Authorized official
DENNIE R UNDERWOOD (VP/OPERATIONS, EDU & RESEARCH)
(704) 355-3147
Entity
Organization
Contact information
Practice address
487 LAKE CONCORD RD NE, CONCORD, NC 28025-2934
(704) 446-0887
Mailing address
PO BOX 601372, CHARLOTTE, NC 28260-1372
(704) 446-0887
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
—
NULL
207R00000X
Internal Medicine Physician
—
—
207RS0010X
Sports Medicine (Internal Medicine) Physician
—
NULL
207RS0010X
Sports Medicine (Internal Medicine) Physician
—
—
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
NULL
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
—
Other
Enumeration date
07/12/2013
Last updated
07/12/2013
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