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Organization
CMC-NORTHEAST, INC.
Active
Organization
CMC-NORTHEAST, INC.
Active
Parent organization
CMC-NORTHEAST, INC.
Other names
NORTHEAST INPATIENT SERVICES
Organization subpart
Yes
Provider details
NPI number
Legal business name
CMC-NORTHEAST, INC.
Authorized official
FRIEDA M LOWDER (VP PHYSICIAN SERVICES)
(704) 403-4146
Entity
Organization
Contact information
Practice address
920 CHURCH ST N, NORTHEAST INPATIENT SERVICES, CONCORD, NC 28025-2927
(704) 403-1331
(704) 403-2533
Mailing address
920 CHURCH ST N, NORTHEAST INPATIENT SERVICES, CONCORD, NC 28025-2927
(704) 403-1331
(704) 403-2533
Taxonomy
Speciality
Code
Description
License number
State
208M00000X
Hospitalist Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0160Y
BCBS EFF PRIOR TO 7-1-07
NC
01
—
019G7
BCBS EFF 7-1-07
NC
01
—
125262
WELLPATH GROUP
NC
01
—
2114736
MAMSI
NC
01
—
566000156002
TRICARE STANDARD, NON NWK
NC
05
—
5906851
—
NC
01
—
7234
PARTNERS MEDICARE CHOICE
NC
05
—
890160Y
—
NC
01
—
CC2854
RAILROAD MEDICARE
NC
01
—
DF8926
RAILROAD MEDICARE PTAN
NC
Enumeration date
06/05/2006
Last updated
06/01/2010
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