Organization
NORTHSIDE CARDIOLOGY, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL A BALK MD (MANAGING PARTNER)
(404) 256-2525
Entity
Organization
Contact information
Practice address
5670 PEACHTREE DUNWOODY RD NE, SUITE 880, ATLANTA, GA 30342-1699
(404) 256-2525
(404) 845-4721
Mailing address
5670 PEACHTREE DUNWOODY RD NE, SUITE 880, ATLANTA, GA 30342-1699
(404) 256-2525
(404) 845-4721
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
003677
STATE LICENSE
GA
Enumeration date
08/03/2006
Last updated
08/22/2020
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