Graduated: 1991
NPI: 1679788855
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.