Medical school: UNIVERSITY OF MICHIGAN MEDICAL SCHOOL
Graduated: 1993
NPI: 1235225889
Practice Locations (2)
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
Source: CMS National Downloadable File, September 2026.