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General NPI Number Information
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NPI Number | 1912946922
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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 | 06/05/2006
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Last Update Date | 11/18/2011
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Provider Practice Location Address
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Address Line | 100 MEDICAL PARK DR SUITE 310 - NORTHEAST PEDIATRIC ENDOCRINOLOGY
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City | CONCORD
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State | NC
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Zip | 28025-2966
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Country | US
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Telephone | 704-403-2660
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Fax | 704-403-2670
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Provider Business Mailing Address
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Address Line | 100 MEDICAL PARK DR SUITE 310 - NORTHEAST PEDIATRIC ENDOCRINOLOGY
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City | CONCORD
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State | NC
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Zip | 28025-2966
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Country | US
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Telephone | 704-403-2660
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Fax | 704-403-2670
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Authorized Official
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Title or Position | VP PHYSICIAN SERVICES
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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 | 2080P0205X
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Taxonomy Name | Pediatric Endocrinology Physician
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License Number |
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License Number State |
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