Graduated: 1992
NPI: 1528050804
Practice Locations (2)
THE SOUTHEAST PERMANENTE MEDICAL GROUP
3495 PIEDMONT RD NE
ATLANTA, GA 303051729
4043647206
THE SOUTHEAST PERMANENTE MEDICAL GROUP
750 TOWNPARK LN NW
KENNESAW, GA 301445579
7705145405
Source: CMS National Downloadable File, September 2026.