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General NPI Number Information
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NPI Number | 1518237825
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Entity Type | Organization
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Legal Business Name | CAROLINAS MEDICAL CENTER-NORTHEAST
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Dates
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Enumeration Date | 01/03/2012
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Last Update Date | 03/28/2012
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Provider Practice Location Address
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Address Line | 200 MEDICAL PARK DRIVE SUITE 320
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City | CONCORD
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State | NC
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Zip | 28025-0936
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Country | US
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Telephone | 704-403-2777
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Fax | 704-403-2779
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Provider Business Mailing Address
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Address Line | 200 MEDICAL PARK DRIVE SUITE 320
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City | CONCORD
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State | NC
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Zip | 28025-0936
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Country | US
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Telephone | 704-403-2777
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Fax | 704-403-2779
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Authorized Official
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Title or Position | SR. VICE PRESIDENT
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Name | FRIEDA M LOWDER
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Credential |
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Telephone | 704-403-4146
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number |
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License Number State |
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