# WELLSTAR MEDICAL GROUP, LLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** WELLSTAR MEDICAL GROUP, LLC
- **Other names:** WellStar Endocrinology
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1669752911
- **Legal business name:** WELLSTAR MEDICAL GROUP, LLC
- **Authorized official:** MRS. NICOLE ASHE (EXECUTIVE DIRECTOR OF FINANCE)
- **Authorized official phone:** (470) 644-0095

## Contact information

- **Practice address:** 3747 ROSWELL RD NE, SUITE 212, MARIETTA, GA 30062-6215
- **Practice address phone:** (678) 403-4300
- **Practice address fax:** (770) 999-2166
- **Mailing address:** 3747 ROSWELL RD NE, SUITE 212, MARIETTA, GA 30062-6215
- **Mailing address phone:** (678) 403-4300
- **Mailing address fax:** (770) 999-2166

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207RE0101X | Endocrinology, Diabetes & Metabolism Physician | — | GA | Yes |

## Other

- **Enumeration date:** 08/18/2011
- **Last updated:** 06/08/2015