Medical school: CHICAGO COLLEGE OF OSTEOPATHY
Graduated: 1980
NPI: 1003966094
Practice Locations (2)
PRIVIA MEDICAL GROUP OF GEORGIA LLC
101 YORKTOWN DR
FAYETTEVILLE, GA 302141578
PRIVIA MEDICAL GROUP OF GEORGIA LLC
101 YORKTOWN DR, SUITE 100
FAYETTEVILLE, GA 302147663
7704604285
Source: CMS National Downloadable File, September 2026.