Graduated: 1991
NPI: 1063521979
Practice Locations (4)
NORTHSIDE PRIMARY CARE PROFESSIONAL SERVICES,LLC
725 WALTHER RD, BLDG 200
LAWRENCEVILLE, GA 300468725
7703385070
NORTHSIDE PRIMARY CARE PROFESSIONAL SERVICES,LLC
3340 PADDOCK PKWY
SUWANEE, GA 300249119
6786796210
NORTHSIDE PRIMARY CARE PROFESSIONAL SERVICES,LLC
3350 PADDOCKS PKWY
SUWANEE, GA 300249119
6784749633
NORTHSIDE PRIMARY CARE PROFESSIONAL SERVICES,LLC
3380 PADDOCKS PKWY
SUWANEE, GA 300249119
6784749633
Source: CMS National Downloadable File, September 2026.