Organization
WELLSTAR MEDICAL GROUP, LLC
Active
Parent organization
WELLSTAR MEDICAL GROUP, LLC
Other names
WellStar Pediatric & Adolescent Center
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
1810 MULKEY RD, SUITE 201, AUSTELL, GA 30106-1151
(770) 819-9262
(770) 819-0597
Mailing address
1810 MULKEY RD, SUITE 201, AUSTELL, GA 30106-1151
(770) 819-9262
(770) 819-0597
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
GA
Other
Enumeration date
02/08/2011
Last updated
11/18/2013
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