| Northside Medical Specialists | |
|
145 Riverstone Terrace Suite 100 Canton GA 30114-5257 | |
| (770) 704-9499 | |
| (770) 704-9754 |
| Full Name | Northside Medical Specialists |
|---|---|
| Speciality | Internal Medicine |
| Location | 145 Riverstone Terrace, Canton, Georgia |
| Authorized Official Name and Position | Christina M Swafford (OFFICE MANAGER) |
| Authorized Official Contact | 7707049499 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Northside Medical Specialists 145 Riverstone Terrace Suite 100 Canton GA 30114-5257 Ph: (770) 704-9499 | Northside Medical Specialists 145 Riverstone Terrace Suite 100 Canton GA 30114-5257 Ph: (770) 704-9499 |
| NPI Number | 1265645063 |
|---|---|
| Provider Enumeration Date | 05/08/2007 |
| Last Update Date | 06/30/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265645063 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 047083 (Georgia) | Primary |
| 207RG0100X | Internal Medicine - Gastroenterology | 046761 (Georgia) | Secondary |
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