Organization
CMC - NORTHEAST, INC.
Active
Parent organization
CMC - NORTHEAST, INC.
Other names
NorthEast Pediatric Pulmonology-Charlotte
Organization subpart
Yes
Provider details
NPI number
Legal business name
CMC - NORTHEAST, INC.
Authorized official
FRIEDA M LOWDER (SR VP)
(704) 403-4146
Entity
Organization
Contact information
Practice address
1001 BLYTHE BLVD, SUITE 200D NORTHEAST PEDIATRIC PULMONLOGY-CHARLOTTE, CHARLOTTE, NC 28203-5866
(704) 403-2660
(704) 403-2670
Mailing address
1001 BLYTHE BLVD, SUITE 200D NORTHEAST PEDIATRIC PULMONLOGY-CHARLOTTE, CHARLOTTE, NC 28203-5866
(704) 403-2660
(704) 403-2670
Taxonomy
Speciality
Code
Description
License number
State
2080P0214X
Pediatric Pulmonology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5914618
—
NC
01
—
DF8926
RAILROAD MEDICARE PTAN
NC
05
—
QPB689
—
SC
Enumeration date
03/11/2010
Last updated
11/15/2011
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