Organization
NORTHSIDE MATERNIDAD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NEALE P. FREEMAN M.D. (OWNER)
(678) 585-4787
Entity
Organization
Contact information
Practice address
5395 JIMMY CARTER BLVD, SUITE 500, NORCROSS, GA 30093-1502
(678) 585-4787
(470) 375-8759
Mailing address
5395 JIMMY CARTER BLVD, SUITE 500, NORCROSS, GA 30093-1502
(678) 585-4787
(470) 375-8759
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
040065
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003169207A
—
GA
Enumeration date
02/18/2016
Last updated
02/18/2016
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