Organization
CAROLINAS MEDICAL CENTER-NORTHEAST
Active
Parent organization
CAROLINAS MEDICAL CENTER-NORTHEAST
Other names
NORTHEAST INTERNAL AND INTEGRATIVE MEDICINE
Organization subpart
Yes
Provider details
NPI number
Legal business name
CAROLINAS MEDICAL CENTER-NORTHEAST
Authorized official
FRIEDA M LOWDER (VP)
(704) 403-4146
Entity
Organization
Contact information
Practice address
707 MEMORIAL BLVD, CONCORD, NC 28025-2975
(704) 403-4050
(704) 403-7059
Mailing address
707 MEMORIAL BLVD, CONCORD, NC 28025-2975
(704) 403-4050
(704) 403-7059
Taxonomy
Speciality
Code
Description
License number
State
175F00000X
Naturopath
—
—
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
019FJ
BCBS EFF 7/1/07
NC
05
—
5906979
—
NC
01
—
DF8926
RAILROAD MEDICARE PTAN
NC
Enumeration date
06/08/2007
Last updated
03/20/2013
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