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Organization
CAROLINAS MEDICAL CENTER-NORTHEAST
Active
Organization
CAROLINAS MEDICAL CENTER-NORTHEAST
Active
Parent organization
CAROLINAS MEDICAL CENTER-NORTHEAST
Other names
NORTHEAST ENDOCRINOLOGY
Organization subpart
Yes
Provider details
NPI number
Legal business name
CAROLINAS MEDICAL CENTER-NORTHEAST
Authorized official
FRIEDA M LOWDER (VP PHYSICIAN SERVICES)
(704) 403-4146
Entity
Organization
Contact information
Practice address
1085 NORTHEAST GATEWAY COURT, NE, SUITE 330, CONCORD, NC 28025-2406
(704) 403-8320
(704) 403-8321
Mailing address
1085 NORTHEAST GATEWAY COURT, NE, SUITE 330, CONCORD, NC 28025-2406
(704) 403-8320
(704) 403-8321
Taxonomy
Speciality
Code
Description
License number
State
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0147R
BCBS EFF PRIOR TO 7-1-07
NC
01
—
019F1
BCBS EFF 7-1-07
NC
01
—
355573
MAMSI
NC
01
—
566000156025
TRICARE STANDARD, NON NWK
NC
05
—
5906970
—
NC
01
—
7368
PARTNERS MEDICARE CHOICE
NC
05
—
890147R
—
NC
01
—
CC2854
RAILROAD MEDICARE
NC
01
—
DF8926
RAILROAD MEDICARE PTAN
NC
Enumeration date
06/05/2006
Last updated
08/07/2012
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