Grant C Wolfe (NPI# 1033319744, PAC ID# 3779726161) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is GENERAL SURGERY.
| Nation Provider ID (NPI) | 1033319744 |
| PAC ID by PECOS | 3779726161 |
| Professional Enrollment ID | I20130904000622 |
| Full Name | Grant C Wolfe |
| Organization Legal Name | NORTHSIDE SURGICAL PROFESSIONAL SERVICES LLC |
| Address |
900 Towne Lake Pkwy Suite 412 Woodstock GA 30189-1604 |
| Phone Number | 7709249656 |
| Gender | M |
| Medical School | JEFFERSON MEDICAL COLLEGE OF THOMAS JEFFERSON UNIVERSITY |
| Graduation Year | 2007 |
| Primary Specialty | GENERAL SURGERY |
| Group Practice PAC ID | 8628253424 |
| Number of Group Practice Members | 161 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 110008 | NORTHSIDE HOSPITAL CHEROKEE |
| Address | Phone | Organization |
|---|---|---|
| 900 Towne Lake Pkwy, Suite 412, Woodstock, GA 30189-1604 | 7709249656 | NORTHSIDE SURGICAL PROFESSIONAL SERVICES LLC |
| Organization Legal Name | NORTHSIDE SURGICAL PROFESSIONAL SERVICES LLC |
| Physicians | 168 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Jessica F Wysock | Nurse Practitioner | Northside Surgical Professional Services LLC | 1100 Northside Forsyth Dr, Suite 410, Cumming, GA 30041-6015 |
| Torrance Christopher Laury | Family Medicine | Northside Surgical Professional Services LLC | 2000 Howard Farm Dr, Suite 305, Cumming, GA 30041-6075 |
| Tayler Mauldin | Nurse Practitioner | Northside Surgical Professional Services LLC | 460 Northside Cherokee, Suite 410, Canton, GA 30115-8016 |
| Eddie K Abdalla | General Surgery | Northside Surgical Professional Services LLC | 980 Johnson Fy Rd Ne, Suite 170, Atlanta, GA 30342-1607 |
| Kelley Dawn Harrelson | Nurse Practitioner | Northside Surgical Professional Services LLC | 759 Old Norcross Rd, Lawrenceville, GA 30046-4317 |
| Soyini Mattis Hawkins | Obstetrics/gynecology | Northside Surgical Professional Services LLC | 11975 Morris Rd, Suite 140, Alpharetta, GA 30005-4444 |
| Pauline Elizabeth Mallcott | Qualified Audiologist | Northside Surgical Professional Services LLC | 4150 Deputy Bill Cantrall Memorial Rd, Suite 260, Cumming, GA 30005 |
| Crystal R Dininger | Physician Assistant | Northside Surgical Professional Services LLC | 1366 Wellbrook Cir Ne, Suite B, Conyers, GA 30012-3872 |
| Rama K Rao | Obstetrics/gynecology | Northside Surgical Professional Services LLC | 2001 Peachtree Nerd, Suite 650, Atlanta, GA 30309-1432 |
| Christopher D Killingsworth | Plastic and Reconstructive Surgery | Northside Surgical Professional Services LLC | Atlanta Aesthetics, 4150 Deputy Bill Cantrall Memorial Road Suite 240, Cumming, GA 30040 |
| Street Address |
900 TOWNE LAKE PKWY SUITE 412 |
| City | WOODSTOCK |
| State | GA |
| Zip | 30189-1604 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Reagan O'connor | Nurse Practitioner | Physician's Express Care At Towne Lake LLC | 900 Towne Lake Pkwy, Suite 104, Woodstock, GA 30189-1603 |
| Cesar Cruz Aguilar | Cardiac Electrophysiology | Northside Cardiovascular Professional Services,llc | 900 Towne Lake Pkwy, Suite 400, Woodstock, GA 30189-1604 |
| Nicole Tabatha Rivera | Physician Assistant | Aga Professional Services LLC | 900 Towne Lake Pkwy, Suite 308, Woodstock, GA 30189-1604 |
| Anand Shantha | Urology | Georgia Urology, Pa | 900 Towne Lake Pkwy, Suite 200, Woodstock, GA 30189-1603 |
| James M Elmore | Urology | Georgia Urology, Pa | 900 Towne Lake Pkwy, Suite 200, Woodstock, GA 30189-1603 |
| Andrew J Kirsch | Urology | Georgia Urology, Pa | 900 Towne Lake Pkwy, Suite 200, Woodstock, GA 30189-1603 |
| Beniam Tefera Abebe | Physician Assistant | Georgia Urology, Pa | 900 Towne Lake Pkwy, Suite 200, Woodstock, GA 30189-1603 |
| Robert S Kaufmann | Internal Medicine | The Kaufmann Clinic Inc | 900 Towne Lake Pkwy, Suite 300, Woodstock, GA 30189-1604 |
| Adamantios Michael Mellis | Urology | Georgia Urology, Pa | 900 Towne Lake Pkwy, Suite 200, Woodstock, GA 30189-1603 |
| Eden Y Shapiro | Urology | Georgia Urology, Pa | 900 Towne Lake Pkwy, Suite 200, Woodstock, GA 30189-1603 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Lili D Gipson | Chiropractic | 715 A Bascomb Comm Pkwy, Woodstock, GA 30189 | |
| Carrie E Tyner | Nurse Practitioner | Minute Clinic LLC | 1600 Towne Lake Pkwy, Woodstock, GA 30189-1585 |
| Paula S Thibault | Nurse Practitioner | Minute Clinic LLC | 1600 Towne Lake Pkwy, Woodstock, GA 30189-1585 |
| Naomi S Morson | Nurse Practitioner | Minute Clinic LLC | 1600 Towne Lake Pkwy, Woodstock, GA 30189-1585 |
| Victoria M Wermers | Nurse Practitioner | Piedmont Professional Services, LLC | 950 Towne Lake Pkwy, Woodstock, GA 30189-1601 |
| Safiah Vafaeian | Nurse Practitioner | Piedmont Professional Services, LLC | 950 Towne Lake Pkwy, Woodstock, GA 30189-1601 |
| Fernando A Duralde | Urology | Georgia Urology, Pa | 900 Towne Lake Pkwy, Suite 200, Woodstock, GA 30189-1603 |
| Graham B Matthews | Family Medicine | Perimeter Professional Services, LLC | 900 Towne Lake Pkwy, Suite 210, Woodstock, GA 30189-1603 |
| Emily Ussery | Nurse Practitioner | Physician's Express Care At Towne Lake LLC | 900 Towne Lake Pkwy, Suite 104, Woodstock, GA 30189-1603 |
| Darrell J Carmen | Urology | Georgia Urology, Pa | 900 Towne Lake Pkwy, Suite 200, Woodstock, GA 30189-1603 |
| Find all physicians in zip 30189 | |||
| City | WOODSTOCK |
| Zip Code | 30189 |
| Specialty | GENERAL SURGERY |
| City + Specialty | WOODSTOCK + GENERAL SURGERY |
Please comment or provide details below to improve the information on Grant C Wolfe.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.