Organization
CAROLINAS MEDICAL CENTER-NORTHEAST
Active
Parent organization
CAROLINAS MEDICAL CENTER-NORTHEAST
Other names
Heart Success Clinic
Organization subpart
Yes
Provider details
NPI number
Legal business name
CAROLINAS MEDICAL CENTER-NORTHEAST
Authorized official
FRIEDA M LOWDER (VICE PRESIDENT)
(704) 403-4146
Entity
Organization
Contact information
Practice address
1090 NORTHEAST GATEWAY COURT, NE, SUITE 101, CONCORD, NC 28025-2424
(704) 403-9177
(704) 403-9178
Mailing address
1090 NORTHEAST GATEWAY COURT, NE, SUITE 101, CONCORD, NC 28025-2424
(704) 403-9177
(704) 403-9178
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
232009
MEDICARE PTAN, GROUP
NC
05
—
5920091
—
NC
Enumeration date
03/30/2012
Last updated
07/12/2012
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