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Organization

CMC-NORTHEAST, INC.

Active
Parent organization
CMC-NORTHEAST, INC.
Other names
NORTHEAST INFECTIOUS DISEASES
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
200 MEDICAL PARK DR, STE 208, NORTHEAST INFECTIOUS DISEASES, CONCORD, NC 28025-2982
(704) 403-1766
(704) 403-1096
Mailing address
200 MEDICAL PARK DR, STE 208, NORTHEAST INFECTIOUS DISEASES, CONCORD, NC 28025-2982
(704) 403-1766
(704) 403-1096

Taxonomy

Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
019FX
BCBS EFF 7-1-07
NC
01
0233R
BCBS EFF PRIOR TO 7-1-07
NC
01
355573
MAMSI GROUP
NC
01
566000156002
TRICARE STANDARD, NON NWK
NC
05
5906967
NC
01
7390
PARTNERS MEDICARE CHOICE
NC
05
890233R
NC
01
CC2854
RAILROAD MEDICARE GROUP
NC
01
DF8926
RAILROAD MEDICARE PTAN
NC
Enumeration date
06/05/2006
Last updated
06/01/2010
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