Organization
WELLSTAR MEDICAL GROUP, LLC
Active
Parent organization
WELLSTAR MEDICAL GROUP, LLC
Other names
WellStar Internal Medicine GAIM
Organization subpart
Yes
Provider details
NPI number
Legal business name
WELLSTAR MEDICAL GROUP, LLC
Authorized official
MRS. NICOLE ASHE (EXECUTIVE VP OF FINANCE)
(470) 644-0095
Entity
Organization
Contact information
Practice address
3825 MEDICAL PARK DR, SUITE 201, AUSTELL, GA 30106-6831
(770) 941-8100
(770) 948-0771
Mailing address
3825 MEDICAL PARK DR, SUITE 201, AUSTELL, GA 30106-6831
(770) 941-8100
(770) 948-0771
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
GA
Other
Enumeration date
12/06/2010
Last updated
11/18/2013
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