Organization
CMC-NORTHEAST, INC.
Active
Parent organization
CMC-NORTHEAST, INC.
Other names
PIEDMONT PEDIATRICS
Organization subpart
Yes
Provider details
NPI number
Legal business name
CMC-NORTHEAST, INC.
Authorized official
FRIEDA M LOWDER (VP PHYSICIAN SERVICES)
(704) 403-4146
Entity
Organization
Contact information
Practice address
1085 NE GATEWAY CT, SUITE 290, PIEDMONT PEDIATRICS, CONCORD, NC 28025-2406
(704) 403-4650
(704) 403-4656
Mailing address
1085 NE GATEWAY CT, SUITE 290, PIEDMONT PEDIATRICS, CONCORD, NC 28025-2406
(704) 403-4650
(704) 403-4656
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
019GK
BCBS EFF 7-1-07
NC
01
—
02233
BCBS EFF PRIOR TO 7-1-07
NC
01
—
355573
MAMSI
NC
01
—
566000156045
TRICARE STANDARD, NON NWK
NC
05
—
5906965
—
NC
05
—
89012YJ
—
NC
01
—
CC2854
RAILROAD MEDICARE
NC
01
—
DF8926
RAILROAD MEDICARE PTAN
NC
01
—
G708
PARTNERS MEDICARE CHOICE
NC
Enumeration date
06/05/2006
Last updated
06/01/2010
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