Graduated: 2025
NPI: 1417767088
Practice Locations (2)
NORTHERN HOSPITAL OF SURRY COUNTY
830 ROCKFORD ST
MOUNT AIRY, NC 270305322
3367838374
LAKE SPRING PHYSICIAN SERVICES, LLC
1900 ELECTRIC RD
SALEM, VA 241537474
5407764000
Source: CMS National Downloadable File, September 2026.