Organization
CAROLINAS MEDICAL CENTER-NORTHEAST
Active
Parent organization
CAROLINAS MEDICAL CENTER-NORTHEAST
Other names
OCCUPATIONAL MEDICINE SERVICES
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
1090 NORTHEAST GATEWAY COURT NE, SUITE 201, CONCORD, NC 28025-2440
(704) 403-9000
(704) 403-9001
Mailing address
1090 NORTHEAST GATEWAY COURT NE, SUITE 201, CONCORD, NC 28025-2440
(704) 403-9000
(704) 403-9001
Taxonomy
Speciality
Code
Description
License number
State
2083X0100X
Occupational Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
013NT
BCBS GROUP ID
NC
01
—
019FC
BCBS EFF 7-1-07
NC
01
—
355573
MAMSI
NC
01
—
566000156060
TRICARE STANDARD, NON NWK
NC
01
—
CC2854
RAILROAD MEDICARE
NC
01
—
DF8926
RAILROAD MEDICARE PTAN
NC
01
—
H802
PARTNERS MEDICARE CHOICE
NC
Enumeration date
06/05/2006
Last updated
02/14/2012
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