# WELLSTAR MEDICAL GROUP, LLC

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

## Provider details

- **NPI number:** 1699065573
- **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:** 55 WHITCHER ST NE, SUITE 130, MARIETTA, GA 30060-1156
- **Practice address phone:** (770) 426-1629
- **Practice address fax:** (770) 427-8001
- **Mailing address:** 55 WHITCHER ST NE, SUITE 130, MARIETTA, GA 30060-1156
- **Mailing address phone:** (770) 426-1629
- **Mailing address fax:** (770) 427-8001

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2086S0127X | Trauma Surgery Physician | — | GA | Yes |

## Other

- **Enumeration date:** 04/13/2011
- **Last updated:** 06/05/2015