Medical school: MEDICAL UNIVERSITY OF SOUTH CAROLINA COLLEGE OF MEDICINE
Graduated: 1992
NPI: 1033143409
Practice Locations (2)
ST LUKES CLINIC - WOOD RIVER LLC
100 HOSPITAL DR
KETCHUM, ID 833409998
2087278800
BALLANTYNE EMERGENCY PHYSICIANS PLLC
11516 PROVIDENCE RD
CHARLOTTE, NC 282772691
7046670370
Source: CMS National Downloadable File, September 2026.