Physician Compare National (NPI:1548253941)

HEALTHCARE PROVIDER: FRANK PUHALOVICH M.D.

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1548253941
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	4082893862
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20110126000039
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	PUHALOVICH
	Individual professional last name
Provider First Name	FRANK
	Individual professional first name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	EMORY UNIVERSITY SCHOOL OF MEDICINE
	Individual professional's medical school
Graduation Year	1989
	Individual professional's medical school graduation year
Primary Specialty	NEUROLOGY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	LAKESIDE NEUROLOGY, P.C.
	Legal name of the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Group Practice PAC ID	0143584250
	Unique Group Practice ID assigned by PECOS to the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Number of Group Practice members	2
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	1100 NORTHSIDE FORSYTH DR
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 440
	Group Practice or individual's line 2 address
City	CUMMING
	Group Practice or individual's city
State	GA
	Group Practice or individual's state
Zip Code	300416015
	Group Practice or individual's zip code (9 digits when available)
Phone Number	7707511589
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	110005
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	NORTHSIDE HOSPITAL FORSYTH
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	110198
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	WELLSTAR NORTH FULTON HOSPITAL
	Legal business name of hospital where individual professional provides service 2
Professional Accepts Medicare Assignment	M