Graduated: 1991
NPI: 1528136900
Practice Locations (2)
THE SOUTHEAST PERMANENTE MEDICAL GROUP
3495 PIEDMONT RD NE
ATLANTA, GA 303051729
4043647206
THE SOUTHEAST PERMANENTE MEDICAL GROUP
200 CRESCENT CTR PKWY
TUCKER, GA 300847047
4043650966
Source: CMS National Downloadable File, September 2026.