Graduated: 2020
NPI: 1457963712
Practice Locations (3)
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
450 NORTHSIDE CHEROKEE BLVD
CANTON, GA 301158015
7702241000
Source: CMS National Downloadable File, September 2026.