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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 NWGFP
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
2513 SHALLOWFORD RD, BUILDING 100, MARIETTA, GA 30066-6809
(770) 516-3500
(770) 516-3600
Mailing address
2513 SHALLOWFORD RD, BUILDING 100, MARIETTA, GA 30066-6809
(770) 516-3500
(770) 516-3600
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
GA
Other
Enumeration date
08/03/2011
Last updated
09/08/2011
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