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Organization

CAROLINAS MEDICAL CENTER-NORTHEAST

Active
Parent organization
CAROLINAS MEDICAL CENTER-NORTHEAST
Other names
CAROLINA INTERNAL MEDICINE-CONCORD
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
200 MEDICAL PARK DR, SUITE 300, CONCORD, NC 28025-2982
(704) 403-3676
(704) 403-3666
Mailing address
200 MEDICAL PARK DR, SUITE 300, CONCORD, NC 28025-2982
(704) 403-3676
(704) 403-3666

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
017EW
BCBS EFF PRIOR TO 7-1-07
NC
01
019F2
BCBSNC
NC
01
355573
MAMSI GROUP ID
NC
01
566000156065
TRICARE
NC
05
5901373
NC
05
5906962
NC
01
CN2098
RAILROAD GROUP ID
NC
01
DF8926
RAILROAD MEDICARE PTAN
NC
01
J386
PARTNERS MEDICARE CHOICE
NC
Enumeration date
06/05/2006
Last updated
08/27/2013
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