Organization
NORTHSIDE PULMONARY & SLEEP MEDICINE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
USHA G NAYAK M.D (CEO)
(678) 999-7576
Entity
Organization
Contact information
Practice address
1400 NORTHSIDE FORSYTH DR, SUITE 280, CUMMING, GA 30041-7668
(678) 999-7576
(678) 455-0010
Mailing address
1400 NORTHSIDE FORSYTH DR, SUITE 280, CUMMING, GA 30041-7668
(678) 999-7576
(678) 455-0010
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
—
—
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
—
—
207RP1001X
Pulmonary Disease Physician
Primary
—
—
207RS0012X
Sleep Medicine (Internal Medicine) Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
511G700613
MEDICARE PTAN
—
Enumeration date
05/13/2008
Last updated
05/06/2010
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