# NORTHSIDE MATERNIDAD

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1477912475
- **Authorized official:** NEALE P. FREEMAN M.D. (OWNER)
- **Authorized official phone:** (678) 585-4787

## Contact information

- **Practice address:** 5395 JIMMY CARTER BLVD, SUITE 500, NORCROSS, GA 30093-1502
- **Practice address phone:** (678) 585-4787
- **Practice address fax:** (470) 375-8759
- **Mailing address:** 5395 JIMMY CARTER BLVD, SUITE 500, NORCROSS, GA 30093-1502
- **Mailing address phone:** (678) 585-4787
- **Mailing address fax:** (470) 375-8759

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM2500X | Medical Specialty Clinic/Center | 040065 | GA | Yes |

## Other

- **Enumeration date:** 02/18/2016
- **Last updated:** 02/18/2016

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 003169207A | — | GA |