Organization
CAROLINAS MEDICAL CENTER-NORTHEAST
Active
Parent organization
CAROLINAS MEDICAL CENTER-NORTHEAST
Other names
NorthEast Plastic & Reconstructive Surgery-Albemarle
Organization subpart
Yes
Provider details
NPI number
Legal business name
CAROLINAS MEDICAL CENTER-NORTHEAST
Authorized official
FRIEDA MILLER LOWDER (SR. VICE PRESIDENT)
(704) 403-4146
Entity
Organization
Contact information
Practice address
105 YADKIN STREET, SUITE 203, ALBEMARLE, NC 28001-3459
(704) 403-2760
(704) 403-2779
Mailing address
105 YADKIN STREET, SUITE 203, ALBEMARLE, NC 28001-3459
(704) 403-2760
(704) 403-2779
Taxonomy
Speciality
Code
Description
License number
State
2086S0122X
Plastic and Reconstructive Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
232009
MEDICARE PTAN, GROUP
NC
05
—
5920089
—
NC
Enumeration date
03/30/2012
Last updated
07/12/2012
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