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Organization
WELLSTAR MEDICAL GROUP, LLC
Active
Organization
WELLSTAR MEDICAL GROUP, LLC
Active
Parent organization
WELLSTAR MEDICAL GROUP, LLC
Other names
WellStar Complex Care Clinic
Organization subpart
Yes
Provider details
NPI number
Legal business name
WELLSTAR MEDICAL GROUP, LLC
Authorized official
MRS. NICOLE ASHE (EXECUTIVE DIRECTOR OF FINANCE)
(470) 644-0095
Entity
Organization
Contact information
Practice address
355 TOWER RD NE, 1ST FLOOR, MARIETTA, GA 30060-9408
(470) 644-0029
(770) 499-0352
Mailing address
355 TOWER RD NE, 1ST FLOOR, MARIETTA, GA 30060-9408
(470) 644-0029
(770) 499-0352
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
—
GA
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
—
GA
Other
Enumeration date
10/16/2014
Last updated
10/16/2014
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