# NORTHSIDE HOSPITAL

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

## Provider details

- **NPI number:** 1598673758
- **Authorized official:** AQUILES DUERO III RN (RN)
- **Authorized official phone:** (770) 224-2000

## Contact information

- **Practice address:** 450 NORTHSIDE CHEROKEE BLVD, CANTON, GA 30115-8015
- **Practice address phone:** (770) 224-2000
- **Mailing address:** 1000 JOHNSON FERRY RD, SANDY SPRINGS, GA 30342-1611

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 163WC0200X | Critical Care Medicine Registered Nurse | — | NULL | Yes |
| 163WC0200X | Critical Care Medicine Registered Nurse | — | — | Yes |

## Other

- **Enumeration date:** 08/31/2026
- **Last updated:** 08/31/2026