Medical school: WRIGHT STATE UNIVERSITY BOONSHOFT SCHOOL OF MEDICINE
Graduated: 1991
NPI: 1124086020
Practice Locations (3)
SOUTHSIDE MEDICAL CENTER, INC.
1046 RIDGE AVE SW
Atlanta, GA 303151640
SOUTHSIDE MEDICAL CENTER, INC.
1046 RIDGE AVE SW
ATLANTA, GA 303151640
4046881350
PMR GEORGIA HOLDING LLC
1331 MOUNT ZION RD
MORROW, GA 302602357
7706293217
Source: CMS National Downloadable File, September 2026.