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Organization

CAROLINAS MEDICAL CENTER-NORTHEAST

Active
Parent organization
CAROLINAS MEDICAL CENTER-NORTHEAST
Other names
NORTHEAST ENDOCRINOLOGY
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
1085 NORTHEAST GATEWAY COURT, NE, SUITE 330, CONCORD, NC 28025-2406
(704) 403-8320
(704) 403-8321
Mailing address
1085 NORTHEAST GATEWAY COURT, NE, SUITE 330, CONCORD, NC 28025-2406
(704) 403-8320
(704) 403-8321

Taxonomy

Speciality
Code
Description
License number
State
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0147R
BCBS EFF PRIOR TO 7-1-07
NC
01
019F1
BCBS EFF 7-1-07
NC
01
355573
MAMSI
NC
01
566000156025
TRICARE STANDARD, NON NWK
NC
05
5906970
NC
01
7368
PARTNERS MEDICARE CHOICE
NC
05
890147R
NC
01
CC2854
RAILROAD MEDICARE
NC
01
DF8926
RAILROAD MEDICARE PTAN
NC
Enumeration date
06/05/2006
Last updated
08/07/2012
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