Organization
CMC - NORTHEAST, INC.
Active
Other names
NORTHEAST INTERNAL MEDICINE
Organization subpart
No
Provider details
NPI number
Authorized official
FRIEDA M LOWDER (VP PHYSICIAN SERVICES)
(704) 783-4146
Entity
Organization
Contact information
Practice address
130 LAKE CONCORD RD NE, SUITE B NE INTERNAL MEDICINE, CONCORD, NC 28025-1918
(704) 652-7270
(704) 788-1935
Mailing address
130 LAKE CONCORD RD NE, SUITE B NE INTERNAL MEDICINE, CONCORD, NC 28025-1918
(704) 652-7270
(704) 788-1935
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
011XF
BCBS GROUP ID
NC
01
—
355573
MAMSI
NC
01
—
566000156041
TRICARE STANDARD, NON NWK
NC
05
—
89011XF
—
NC
01
—
CC2854
RAILROAD MEDICARE
NC
01
—
F158
PARTNERS MEDICARE CHOICE
NC
Enumeration date
05/28/2006
Last updated
08/22/2020
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