Carolinas Medical Center-Northeast

Organization Active NPI Obstetrics & Gynecology Physician · Davidson, NC

NPI 1477569820 · NPPES record last updated Mar 17, 2014

Key facts

NPI
1477569820
Entity type
Organization (NPI type 2)
Primary specialty
Obstetrics & Gynecology Physician 207V00000X
Legal business name
CAROLINAS MEDICAL CENTER-NORTHEAST
Practice address
2101 Shiloh Church Rd
Suite 202
Davidson, NC 28036-7603
Phone
(704) 439-3770
Fax
(704) 439-3779
NPI assigned
Jul 31, 2006
Organization subpart
Yes
Parent organization (as reported)
CAROLINAS MEDICAL CENTER-NORTHEAST

Authorized official

Name
Frieda M Lowder
Title
VP Physician Services
Phone
(704) 403-4146

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

National Provider Directory

Part of
CMC Northeast

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician
Group: 193400000X SINGLE SPECIALTY GROUP
207V00000X Yes

Addresses

Primary practice location

2101 Shiloh Church Rd
Suite 202
Davidson, NC 28036-7603

Mailing address

2101 Shiloh Church Rd
Suite 202
Davidson, NC 28036-7603
Phone (704) 439-3770

Other identifiers

IdentifierTypeStateIssuer
K076OtherNCPARTNERS MEDICARE CHOICE
019F4OtherNCBCBS EFF 7-1-07
5903802MedicaidNC
5906959MedicaidNC
CC2854OtherNCRAILROAD MEDICARE
566000156079OtherNCTRICARE
DF8926OtherNCRAILROAD MEDICARE PTAN
355573OtherNCMAMSI
018FNOtherNCBCBS GROUP ID

Other names

  • NorthEast Women's Health & Obstetrics at Renaissance Doing business as

Other providers in Davidson, NC

All providers in Davidson, NC · Obstetrics & Gynecology Physician in North Carolina

Sources for this page

Verify at the official NPI Registry.