Medical school: NOVA SOUTHEASTERN UNIV COLLEGE OF DENTAL MEDICINE
Graduated: 1995
NPI: 1356428700
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
EAR, NOSE AND THROAT PLASTIC SURGERY CENTER
6130 PRESTLEY MILL RD C
Douglasville, GA 301342288
EAR, NOSE AND THROAT PLASTIC SURGERY CENTER
6130 PRESTLEY MILL RD, SUITE C
DOUGLASVILLE, GA 301342288
6788383903
Source: CMS National Downloadable File, September 2026.