Graduated: 1997
NPI: 1134118383
Practice Locations (2)
GWINNETT PHYSICIAN GROUP, LLC
1000 MEDICAL CTR BLVD
LAWRENCEVILLE, GA 300467694
6783124321
HOSPITAL PHYSICIAN SERVICES - SOUTHEAST PROFESSIONAL CORPORATION
1700 MEDICAL WAY
SNELLVILLE, GA 300782195
7707362283
Source: CMS National Downloadable File, September 2026.