# CAROLINAS MEDICAL CENTER

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** CAROLINAS MEDICAL CENTER
- **Other names:** Carolinas Rehabilitation Northeast Physician Clinic
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1174964621
- **Legal business name:** CAROLINAS MEDICAL CENTER
- **Authorized official:** DENNIE R UNDERWOOD (VP/OPERATIONS, EDU & RESEARCH)
- **Authorized official phone:** (704) 355-3147

## Contact information

- **Practice address:** 487 LAKE CONCORD RD NE, CONCORD, NC 28025-2934
- **Practice address phone:** (704) 446-0887
- **Mailing address:** PO BOX 601372, CHARLOTTE, NC 28260-1372
- **Mailing address phone:** (704) 446-0887

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 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 | — | NULL | Yes |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | — | Yes |

## Other

- **Enumeration date:** 07/12/2013
- **Last updated:** 07/12/2013