Organization
CAROLINAS MEDICAL CENTER-NORTHEAST
Active
Organization
CAROLINAS MEDICAL CENTER-NORTHEAST
Active
Parent organization
CAROLINAS MEDICAL CENTER-NORTHEAST
Other names
KANNAPOLIS INTERNAL MEDICINE
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
201 DALE EARNHARDT BLVD, SUITE 200, KANNAPOLIS, NC 28083-0303
(704) 932-1155
(704) 932-3500
Mailing address
201 DALE EARNHARDT BLVD, SUITE 200, KANNAPOLIS, NC 28083-0303
(704) 932-1155
(704) 932-3500
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0116M
BCBS EFF PRIOR TO 7-1-07
NC
01
—
019F3
BCBS EFF 7-1-07
NC
01
—
355573
MAMSI GROUP NO
NC
01
—
566000156011
TRICARE STANDARD, NON NWK
NC
05
—
5906968
—
NC
01
—
7231
PARTNERS MEDICARE CHOICE
NC
05
—
890116M
—
NC
01
—
CC2854
RAILROAD MEDICARE GROUP
NC
01
—
DF8926
RAILROAD MEDICARE PTAN
NC
Enumeration date
05/26/2006
Last updated
08/29/2013
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