Medical school: SAINT LOUIS UNIVERSITY SCHOOL OF MEDICINE
Graduated: 2005
NPI: 1043541725
Practice Locations (4)
NORTHSIDE SURGICAL PROFESSIONAL SERVICES LLC
1000 JOHNSON FERRY NE
ATLANTA, GA 303421606
NORTHSIDE SURGICAL PROFESSIONAL SERVICES LLC
1000 JOHNSON FERRY RD NE
ATLANTA, GA 303421606
4048518000
NORTHSIDE SURGICAL PROFESSIONAL SERVICES LLC
1110 W PEACHTREE ST NW
ATLANTA, GA 303093609
NORTHSIDE SURGICAL PROFESSIONAL SERVICES LLC
7823 SPIVEY STATION BLVD, SUITE 310
JONESBORO, GA 302362886
4048470664
Source: CMS National Downloadable File, September 2026.