Organization · Type 2 NPI
Riverside Family Medical
Medical Physician Assistant · Lawrenceville, GA
NPI number
1306980263
Active
Practice location
1960 Riverside Pkwy Ste 106
Lawrenceville, GA 30043-5945
Fax (678) 407-2266
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Family Medicine Physician | 207Q00000X | 034091 (GA) |
| Physical Medicine & Rehabilitation Physician | 208100000X | 049316 (GA) |
| Medical Physician Assistant Primary | 363AM0700X | 002087 (GA) |
Medical Physician Assistant: Definition to come...
Other medical physician assistant providers in Lawrenceville
About NPI 1306980263
Riverside Family Medical's National Provider Identifier is 1306980263, issued on Feb 16, 2007. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in Lawrenceville, GA. The record was last updated on Sep 11, 2025.