Organization
CMC-NORTHEAST, INC.
Active
Parent organization
CMC-NORTHEAST, INC.
Other names
Carolinas Pediatric Neurology Care - Charlotte Specialty Center
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 200 CPNC - CHARLOTTE SPECIALTY CENTER, CHARLOTTE, NC 28203-5866
(704) 381-8840
(704) 381-8848
Mailing address
1001 BLYTHE BLVD, SUITE 200 CPNC - CHARLOTTE SPECIALTY CENTER, CHARLOTTE, NC 28203-5866
(704) 381-8840
(704) 381-8848
Taxonomy
Speciality
Code
Description
License number
State
2084N0402X
Neurology with Special Qualifications in Child Neurology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5916349
—
NC
05
—
NPB455
—
SC
Enumeration date
12/07/2010
Last updated
11/15/2011
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