NORTHSIDE MEDICAL SPECIALISTS NPI 1265645063

NPI Information

  • NPI: 1265645063
  • Provider Name: NORTHSIDE MEDICAL SPECIALISTS
  • Classification: Internal Medicine - 207R00000X
  • Entity Type: Organization
  • Address: 145 RIVERSTONE TERRACE
    SUITE 100
    CANTON, GA
    ZIP 30114
  • Phone: (770) 704-9499

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NPI Details

NORTHSIDE MEDICAL SPECIALISTS is an internal medicine in Canton, GA. The provider is a physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. NORTHSIDE MEDICAL SPECIALISTS NPI is 1265645063. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

145 RIVERSTONE TERRACE
SUITE 100
CANTON, GA
ZIP 30114-257
Phone: (770) 704-9499
Fax: (770) 704-9754

The provider's authorized official is Christina M Swafford .
The authorized official title is Office Manager and has the following contact phone number (770) 704-9499.

The enumeration date for this NPI number is 5/8/2007 and was last updated on 6/30/2010.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207RG0100XInternal MedicineGastroenterology046761GEORGIANo
2207R00000XInternal Medicine047083GEORGIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1G13474MEDICARE UPIN
211BDVDBMEDICARE ID-TYPE UNSPECIFIED
3G21272MEDICARE UPIN
410BBCLGMEDICARE ID-TYPE UNSPECIFIED

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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