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General NPI Number Information
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NPI Number | 1770728487
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Entity Type | Organization
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Legal Business Name | CMC-NORTHEAST, INC.
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Dates
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Enumeration Date | 12/09/2008
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Last Update Date | 08/21/2012
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Provider Practice Location Address
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Address Line | 9625 NORTHCROSS CENTER CT SUITE 102-C
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City | HUNTERSVILLE
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State | NC
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Zip | 28078-7348
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Country | US
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Telephone | 704-801-1240
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Fax | 704-801-1240
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Provider Business Mailing Address
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Address Line | 9625 NORTHCROSS CENTER CT SUITE 102-C
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City | HUNTERSVILLE
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State | NC
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Zip | 28078-7348
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Country | US
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Telephone | 704-801-1240
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Fax | 704-801-1240
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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 | 2080P0214X
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Taxonomy Name | Pediatric Pulmonology Physician
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License Number |
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License Number State |
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