# CAROLINAS MEDICAL CENTER-NORTHEAST

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

## Provider details

- **NPI number:** 1386683472
- **Legal business name:** CAROLINAS MEDICAL CENTER-NORTHEAST
- **Authorized official:** FRIEDA M LOWDER (VP PHYSICIAN SERVICES)
- **Authorized official phone:** (704) 403-4146

## Contact information

- **Practice address:** 1085 NORTHEAST GATEWAY COURT, NE, SUITE 330, CONCORD, NC 28025-2406
- **Practice address phone:** (704) 403-8320
- **Practice address fax:** (704) 403-8321
- **Mailing address:** 1085 NORTHEAST GATEWAY COURT, NE, SUITE 330, CONCORD, NC 28025-2406
- **Mailing address phone:** (704) 403-8320
- **Mailing address fax:** (704) 403-8321

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207RE0101X | Endocrinology, Diabetes & Metabolism Physician | — | — | Yes |

## Other

- **Enumeration date:** 06/05/2006
- **Last updated:** 08/07/2012

## 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 |