Medical school: TEMPLE UNIVERSITY SCHOOL OF MEDICINE
Graduated: 1982
NPI: 1275526386
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
2701 N DECATUR RD
DECATUR, GA 300335918
4045015630
NORTHSIDE SURGICAL PROFESSIONAL SERVICES LLC
1462 MONTREAL RD, SUITE 303
TUCKER, GA 300846924
4045084320
Source: CMS National Downloadable File, September 2026.