Organization
NORTHSIDE MEDICAL SPECIALISTS
Active
Organization
NORTHSIDE MEDICAL SPECIALISTS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTINA M SWAFFORD (OFFICE MANAGER)
(770) 704-9499
Entity
Organization
Contact information
Practice address
145 RIVERSTONE TERRACE, SUITE 100, CANTON, GA 30114-5257
(770) 704-9499
(770) 704-9754
Mailing address
145 RIVERSTONE TERRACE, SUITE 100, CANTON, GA 30114-5257
(770) 704-9499
(770) 704-9754
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
047083
GA
207RG0100X
Gastroenterology Physician
046761
GA
Other
Enumeration date
05/08/2007
Last updated
06/30/2010
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