Organization
CAROLINAS MEDICAL CENTER-NORTHEAST
Active
Parent organization
CAROLINAS MEDICAL CENTER-NORTHEAST
Other names
Ardsley Internal Medicine Renaissance Square
Organization subpart
Yes
Provider details
NPI number
Legal business name
CAROLINAS MEDICAL CENTER-NORTHEAST
Authorized official
FRIEDA M LOWDER (SR VICE PRESIDENT)
(704) 403-4146
Entity
Organization
Contact information
Practice address
2101 SHILOH CHURCH RD, SUITE 201, DAVIDSON, NC 28036-7601
(704) 403-8650
(704) 403-8655
Mailing address
2101 SHILOH CHURCH RD, SUITE 201, DAVIDSON, NC 28036-7601
(704) 403-8650
(704) 403-8655
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
019FV
BCBSNC
NC
05
—
5950094
—
NC
01
—
DF8926
RAILROAD MEDICARE PTAN
NC
Enumeration date
04/29/2008
Last updated
03/28/2014
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