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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 Family Medicine & Internal Medicine AHP
Organization subpart
Yes
Provider details
NPI number
Legal business name
WELLSTAR MEDICAL GROUP, LLC
Authorized official
MRS. NICOLE ASHE (EXECUTIVE DIRECTOR OF FINANCE)
(770) 792-5261
Entity
Organization
Contact information
Practice address
4550 COBB PARKWAY NW, SUITE 201, ACWORTH, GA 30101
(770) 974-4655
(770) 974-7534
Mailing address
4550 COBB PARKWAY NW, SUITE 201, ACWORTH, GA 30101
(770) 974-4655
(770) 974-7534
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
GA
207R00000X
Internal Medicine Physician
—
GA
Other
Enumeration date
07/03/2012
Last updated
07/03/2012
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