Organization
NORTHSIDE EAR, NOSE & THROAT, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANDREW J DIAMOND MD (PRESIDENT)
(770) 475-3361
Entity
Organization
Contact information
Practice address
1360 UPPER HEMBREE RD, 201, ROSWELL, GA 30076-1171
(770) 475-3361
(770) 664-4431
Mailing address
PO BOX 933087, ATLANTA, GA 31193-3087
(770) 475-3361
(770) 664-4431
Taxonomy
Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
059383
GA
207Y00000X
Otolaryngology Physician
Primary
036368
GA
207YX0007X
Plastic Surgery within the Head & Neck (Otolaryngology) Physician
57545
GA
Other
Enumeration date
12/21/2006
Last updated
09/11/2008
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