Organization
CAROLINAS MEDICAL CENTER-NORTHEAST
Active
Organization
CAROLINAS MEDICAL CENTER-NORTHEAST
Active
Parent organization
CAROLINAS MEDICAL CENTER-NORTHEAST
Other names
Northside Internal Medicine
Organization subpart
Yes
Provider details
NPI number
Legal business name
CAROLINAS MEDICAL CENTER-NORTHEAST
Authorized official
FRIEDA M LOWDER (SR VP)
(704) 403-4146
Entity
Organization
Contact information
Practice address
319 PENNY LN, SUITE A, CONCORD, NC 28025-1221
(704) 403-7575
(704) 403-4326
Mailing address
319 PENNY LN, SUITE A, CONCORD, NC 28025-1221
(704) 403-7575
(704) 403-4326
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
232009
MEDICARE PTAN, GROUP
NC
05
—
5916552
—
NC
Enumeration date
01/27/2011
Last updated
07/31/2013
Update your record
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