Organization
CAROLINAS MEDICAL CENTER-NORTHEAST
Active
Parent organization
CAROLINAS MEDICAL CENTER-NORTHEAST
Other names
CAROLINAS WEIGHT LOSS SURGERY
Organization subpart
Yes
Provider details
NPI number
Legal business name
CAROLINAS MEDICAL CENTER-NORTHEAST
Authorized official
FRIEDA M LOWDER (SR VP)
(704) 403-4146
Entity
Organization
Contact information
Practice address
1090 VINEHAVEN DR NE, CONCORD, NC 28025-2438
(704) 786-5700
(704) 786-5703
Mailing address
1090 VINEHAVEN DR NE, CONCORD, NC 28025-2438
(704) 786-5700
(704) 786-5703
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
232009
MEDICARE PTAN, GROUP
NC
05
—
5918864
—
NC
Enumeration date
02/15/2011
Last updated
02/01/2012
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